50-288 page 3
(Rev . 10-07/2)
SCHEDULE A: REPORT OF LEASED VEHICLES
Name of Lessee
Address where vehicle is kept
City, town or post office, state, ZIP code
Phone (area code and number)
County
Vehicle Identification Number
Year
Make
Body Style/Type
Model
Weight***
Lease Date
Purchase Date
Property Owner’s Value Estimate (optional)*
Has the lessee signed an affidavit designating the vehicle as not held for income production and not used for the production of income?
Yes
No
Has the property owner maintained lessee’s affidavit?
Yes
No
Name of Lessee
Address where vehicle is kept
City, town or post office, state, ZIP code
Phone (area code and number)
County
Vehicle Identification Number
Year
Make
Body Style/Type
Model
Weight***
Lease Date
Purchase Date
Property Owner’s Value Estimate (optional)*
Has the lessee signed an affidavit designating the vehicle as not held for income production and not used for the production of income?
Yes
No
Has the property owner maintained lessee’s affidavit?
Yes
No
Name of Lessee
Address where vehicle is kept
City, town or post office, state, ZIP code
Phone (area code and number)
County
Vehicle Identification Number
Year
Make
Body Style/Type
Model
Weight***
Lease Date
Purchase Date
Property Owner’s Value Estimate (optional)*
Has the lessee signed an affidavit designating the vehicle as not held for income production and not used for the production of income?
Yes
No
Has the property owner maintained lessee’s affidavit?
Yes
No
Name of Lessee
Address where vehicle is kept
City, town or post office, state, ZIP code
Phone (area code and number)
County
Vehicle Identification Number
Year
Make
Body Style/Type
Model
Weight***
Lease Date
Purchase Date
Property Owner’s Value Estimate (optional)*
Has the lessee signed an affidavit designating the vehicle as not held for income production and not used for the production of income?
Yes
No
Has the pr
operty owner maintained
lessee’
s affidavit?
Y
es
No
Name
of
Lessee
Address wher vehicle is kept
e
City
, town or post office, state, ZIP code
Phone (ar
ea
code and number)
County
Vehicle Identification Number
Year
Make
Body Style/Type
Model
Weight***
Lease Date
Purchase Date
Property Owner’s Value Estimate (optional)*
Has the lessee signed an affidavit designating the vehicle as not held for income production and not used for the production of income?
Yes
No
Has the property owner maintained lessee’s affidavit?
Yes
No