Personal Property Declaration Form
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5Personal Property Declaration
Assessment date October 1, 2004
List/Account #:
Required return date November 1, 2004
DBA:
Owner’s Name:
Location (street & number):
Direct questions concerning return to -
Location of accounting record -
Name
Address
City/State/Zip
Phone/Fax
Description of business:
Type of Business:
Number of employees
0
Manufacturer
Date business began
Wholesale
Square feet of facilities
Service
Own or lease?
Retail/Mercantile
Type of ownership:
Tradesman
Corporation
Farmer
Partnership
Profession
Sole proprietor
Lessor
LLC
Other:
Other:
Yes/No
In the last 12 months was any of the property included in this declaration located in another Connecticut town for at least 3
months? If yes, identify by specific months, code, cost, and location(s). Yes or No -
Are there any other business operations that may or may not own assets that are operating from your address here in this
town? If yes give name and mailing address. Yes or No -
Do you own tangible personal property that is leased or consigned to others in this town? If yes, complete the Lessor’s Report
(tab - Lessor's Report ). Yes or No -
Did you have in your possession on October 1st any borrowed, consigned, stored or rented property? If yes, complete the
Lessee's Report (tab - Asset Disposal & Lessee's Rpt ). Yes or No -
#17
Farm machinery
#18
Farm tools
Code
Assessment
Year Ending
Original Cost + % Gd
Net Value
Year Ending
Original Cost + % Gd
Net Value
10/1/04
95%
0
10/1/04
95%
0
10/1/03
90%
0
10/1/03
90%
0
10/1/02
80%
0
10/1/02
80%
0
10/1/01
70%
0
10/1/01
70%
0
10/1/00
60%
0
10/1/00
60%
0
#17
0
10/1/99
50%
0
10/1/99
50%
0
10/1/98
40%
0
10/1/98
40%
0
#18
0
30%
0
30%
0
All Prior Years
All Prior Years
Total
0
0
Total
0
0
#12
Commercial fishing apparatus
#19
Mechanics tools
Year Ending
Original Cost + % Gd
Net Value
Year Ending
Original Cost + % Gd
Net Value
10/1/04
95%
0
10/1/04
95%
0
10/1/03
90%
0
10/1/03
90%
0
10/1/02
80%
0
10/1/02
80%
0
10/1/01
70%
0
10/1/01
70%
0
10/1/00
60%
0
10/1/00
60%
0
#12
0
10/1/99
50%
0
10/1/99
50%
0
10/1/98
40%
0
10/1/98
40%
0
#19
0
30%
0
30%
0
All Prior Years
All Prior Years
Total
0
0
Total
0
0
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