State Form 53854 - Single Return - Business Tangible Personal Property Page 2
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1
2SCHEDULE A FOR FORM 103-SR
JANUARY 1, 2017
Part of State Form 53854 (R8 / 11-16)
INSTRUCTIONS:
PLEASE TYPE or PRINT.
This form must be filed with the County Assessor of the county in which the property is located not later than May 15, 2017
unless an extension is granted in writing. Contact information for the Assessor is available at
This form is for use by taxpayers who have personal property in more than one (1) township in a county.
If you are claiming any special adjustments such as equipment not placed in service, special tooling, permanently retired equipment,
abnormal obsolescence, economic revitalization, or other deductions, file the Form 103 Long.
Assign a location number to each separate location within a county.
If more than one page is necessary, attach additional forms and indicate you have done so on the front of the Form 103-SR.
NOTE:
The location numbers shown below must correspond with the locations and location numbers shown on the front of this form (Form 103-SR) and on
the reverse side of Form 104-SR.
The County Assessor may refuse to accept a single personal property tax return that does not have attached to it a schedule listing, by township, all the
personal property of the taxpayer and the assessed value of the property for each taxing district as required. [IC 6-1.1-3-7(e)]
DEPRECIABLE PERSONAL PROPERTY
LOCATION NUMBER
#
#
#
TAXING DISTRICT NUMBER
#
#
#
COLUMN A
COLUMN B
COLUMN A
COLUMN B
COLUMN A
COLUMN B
LINE
YEAR OF ACQUISITION
TTV%
TOTAL COST
TTV
TOTAL COST
TTV
TOTAL COST
TTV
1-2-16 to 1-1-17
1
40%
3-2-15 to 1-1-16
2
60%
3-2-14 to 3-1-15
3
55%
3-2-13 to 3-1-14
4
45%
3-2-12 to 3-1-13
5
37%
3-2-11 to 3-1-12
6
30%
3-2-10 to 3-1-11
7
25%
3-2-09 to 3-1-10
8
20%
3-2-08 to 3-1-09
9
16%
3-2-07 to 3-1-08
10
12%
Prior
to 3-2-07
11
10%
TOTALS
12
30% of line 12, Column A
13
Line 14 must be the greater of Line 12, Column B or Line 13 [see 50 IAC 4.2-4-9]
Total True Tax Value (TTV) of
14
Depreciable Personal Property
(to Summary on Form 103-SR)
DEPRECIABLE PERSONAL PROPERTY
LOCATION NUMBER
#
#
#
TAXING DISTRICT NUMBER
#
#
#
COLUMN A
COLUMN B
COLUMN A
COLUMN B
COLUMN A
COLUMN B
LINE
YEAR OF ACQUISITION
TTV%
TOTAL COST
TTV
TOTAL COST
TTV
TOTAL COST
TTV
1
1-2-16 to 1-1-17
40%
2
3-2-15 to 1-1-16
60%
3
3-2-14 to 3-1-15
55%
4
3-2-13 to 3-1-14
45%
5
3-2-12 to 3-1-13
37%
6
3-2-11 to 3-1-12
30%
7
3-2-10 to 3-1-11
25%
8
3-2-09 to 3-1-10
20%
9
3-2-08 to 3-1-09
16%
10
3-2-07 to 3-1-08
12%
11
Prior
to 3-2-07
10%
12
TOTALS
13
30% of line 12, Column A
Line 14 must be the greater of Line 12, Column B or Line 13 [see 50 IAC 4.2-4-9]
Total True Tax Value (TTV) of
14
Depreciable Personal Property
(to Summary on Form 103-SR)
Page ______ of ______
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