Form 904 - Asset Listing (General)

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Form 904
Page 1 of 2
Asset Listing (General)
Schedule 3
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
Year Acquired
Item
Description
Original
Life
%
Factor
Reclnd
Number
(Furniture, Fixtures, Signs, Machinery, etc.)
Cost
Years
Good
New
Used
Total
Total

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