Connecticut Confidential Report For Personal Property Form - Yearly Summary Schedules - 2007 Page 2

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LESSEE'S REPORT OF PERSONAL PROPERTY
ASSESSMENT DATE: OCTOBER 1, 2007
All leased machinery and equipment in your possession as of the assessment date must be included in this report. FAILURE TO FILE this report, in
the form and manner as herein prescribed, shall result in a presumption of your ownership and subsequent tax liability of any items of leased personal
property in your possession.
Lessee's Name
Name of Business
Business Address, Number, Street, City, State
Lessee's Mailing address (If different than property location)
Model #/
Year
Lease Term
Monthly
Estimated
Owner's (Lessor) Name and Address
Lease #
Item Description
Type
Mfg.
(Start/End)
Rent
Cost
Were any leased items in your possession on 10/1/06, disposed of prior to 10/1/07?
_____Yes
_____ No
If yes, enter description, date of disposal and transferee.

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