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SCHEDULE OF DEDUCTION FROM ASSESSED VALUATION

2006 PAY 2007

PERSONAL PROPERTY IN ECONOMIC REVITALIZATION AREA

State Form 52503 (R / 2-06)

FORM 103 – ERA

Prescribed by the Department of Local Government Finance

PRIVACY NOTICE: The records in

this series are confidential

INSTRUCTIONS:

according to I. C. 6-1.1-35-9.

1. In order to receive a deduction, this schedule must be submitted with a timely filed Form 103-Long.

2. A separate schedule must be completed and attached to the Form 103 for each approved abatement ( Form SB-1/PP ).

3. Attach a copy of the approved (if applicable) Form CF-1 to this schedule. First time filings must also include the SB-1 and the Resolution from the

designating body.

4. For any acquisitions included herein since the last assessment date, attach a list of the newly included equipment on Form 103-EL.

SECTION 1

TAXPAYER INFORMATION

Name of taxpayer

Contact person

Full address (number and street, city, state, and ZIP code)

Telephone number

(

)

County

Township

Taxing District

SECTION 2

ECONOMIC REVITALIZATION AREA INFORMATION

Name of body designating the Economic Revitalization Area

Resolution number

Length of abatement (Years)

Date designation approved (month, day, year)

Date designation will terminate (month, day, year)

Does resolution limit dollar amount of deduction?

YES - and limit is based on equipment

Cost or

Assessed Value

SECTION 3

ABATED EQUIPMENT POOLING SCHEDULE

The total cost of depreciable assets is to be reported on Form 103-Long. This schedule includes only the values attributable to the new

manufacturing, research and development, logistical distribution and/or information technology equipment under abatement per the

Yes

resolution and IC 6-1.1-12.1. Election to report cost of Depreciable Assets by Federal tax year ***

NOTE: See Page 2 of this form for the balance of pooling schedules.

Assessing

* In TTV % and True Tax Value Columns, circle and apply the percentage that the assessment is based upon. If, on the Form 103

Official Use Only

Long, the entry on Line 58 is equal to Line 57, use 30%. If Line 58 is equal to Line 56, use the applicable Pool Percentages.

103 Schedule A

True Tax Value

Abatement

POOL NUMBER 1:

* TTV %

Deduction

Column C

[per 103 or per IC 6-

(1 TO 4 YEAR LIFE)

(circle one)

Claimed

Approved

Year

Percent

Adjusted Cost

1.1-12.1-4.5 (f)] **

from

3-1-06 *** $

65% 30% $

% $

3-2-05

3-1-06

65% 30%

3-2-04

3-1-05

50% 30%

3-2-03

3-1-04

35% 30%

17A

3-2-02

3-1-03

20% 30%

17B

3-2-01

3-1-02

20% 30%

17C

3-2-00

3-1-01

**65% 30%

17D

3-2-99

3-1-00

**65% 30%

17E

3-2-98

3-1-99

**65% 30%

17F

3-2-97

3-1-98

**65% 30%

17G

3-2-96

3-1-97

**65% 30%

TOTAL POOL NUMBER 1

103 Schedule A

True Tax Value

Abatement

POOL NUMBER 2:

* TTV %

Deduction

Column C

[per 103 or per IC 6-

(5 TO 8 YEAR LIFE)

(circle one)

Claimed

Approved

Year

Percent

Adjusted Cost

1.1-12.1-4.5 (f)] **

from

3-1-06 *** $

40% 30% $

% $

3-2-05

3-1-06

40% 30%

3-2-04

3-1-05

56% 30%

3-2-03

3-1-04

42% 30%

3-2-02

3-1-03

32% 30%

3-2-01

3-1-02

24% 30%

3-2-00

3-1-01

**40% 30%

26A

3-2-99

3-1-00

**40% 30%

26B

3-2-98

3-1-99

**40% 30%

26C

3-2-97

3-1-98

**40% 30%

26D

3-2-96

3-1-97

**40% 30%

TOTAL POOL NUMBER 2

SUB-TOTAL- POOLS 1 and 2 (Total lines 18 and 27. Enter to the right and on Page 2)

***

Page 1

If taxpayer elects to report cost on a federal tax year basis, assets acquired from the end of the prior federal tax year to March 1 are reported on the first line.