Form 904-A - Asset Listing (Grouped)
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2Form 904-A
Page 1 of 2
Asset Listing (Grouped)
Schedule 3-A
Revised 7-2006
Taxpayers filing in
County for the first time or
completing OTC Form 901 for the first time: Must complete this schedule listing like
or similar items grouped by description, year of acquisition, original cost and class. This
schedule to be filed with completed rendition.
Name of Business:
Tax Year:
Address:
Personal Property Account Number:
Assessors Use Only
Description
Year Acquired
Item
Original
Life
%
Factor
Reclnd
Number
Cost
Years
Good
Leasehold Improvements
1
New
Used
TOTAL
TOTAL
Item
Year Acquired
Original
Life
%
Factor
Reclnd
Furniture and Fixtures
2
Number
Cost
Years
Good
New
Used
TOTAL
TOTAL
Item
Year Acquired
Original
Life
%
Factor
Reclnd
Electronic Equipment
3
Number
Cost
Years
Good
New
Used
TOTAL
TOTAL
Item
Year Acquired
Original
Life
%
Factor
Reclnd
Computer Equipment
4
Number
Cost
Years
Good
New
Used
TOTAL
TOTAL
Item
Original
Life
%
Year Acquired
Factor
Reclnd
Machinery and Equipment
5
Number
Cost
Years
Good
New
Used
TOTAL
TOTAL
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