Declaration Of Personal Property-Short Form - Greenwich, Connecticut - 2009 Page 3
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Make
(
Model
Identification No .
Lernj , _ ,tft
Width ( Bedrooms
Baths
Value
2009 PERSONAL PROPERTY DECLARATION - SHORT FORM SUMMARY SHEET
Commercial and financial information is
not open to public inspection
Type
of
ownership : EJ Corporation Fj Partnership E] LLC
0
Sole Proprietor
0
Other-Describe
Type of business : E] Manufacturer
0
Wholesale
0
Service
F~
Profession
0
Retail/Mercantile E] Tradesman E] Other
IRS Business Activity Code
Square footage occupied
No . of Employees
#9 Motor Vehicles UNREGISTERED motor vehicles (e .g . campers, RV's, snowmobiles, trailers, trucks, passenger cars, tractors, off-road construction
vehicles, etc.) including any vehicle garaged in Connecticut but registered in another state, or any
such
vehicle not registered at all . If you are a farmer
eligible for the exemption under Sec .
12-91,
list tractors in Code 17.
#11 Horses And Ponies Describe your horses and ponies. A $1,000 assessment exemption per animal will be applied . If you are a farmer, the
exemption may be 100% provided Form
M-28 is
filed with and approved b the Assessor.
#14 Mobile Manufactured Homes if not currently assessed as real estate
Property Code and Description
#12 - Commercial Fishing Apparatus All fishing apparatus exclusively used by a commercial fisherman in his business (e .g .,
fishing poles, nets, lobster pots, fish finders, etc .) . A $500 value exemption will be applied .
#16 - Furniture & Fixtures Furniture, fixtures and equipment of all commercial, industrial, manufacturing, mercantile, trading
and all other businesses, occupation and professions . Examples : desks, chairs, tables, file cabinets, typewriters, calculators,
copy machines, telephones (including mobile telephones), telephone answering machines, facsimile machines, postage meters,
cash registers, moveable air conditioners, partitions, shelving display racks, refrigerators, freezers, kitchen equipment, etc.
#17 - Farm Machinery Farm machinery (e.g., tractors, harrows, bush hogs, hay bines, hay rakes, balers, corn choppers,
milking machines, milk tanks, coolers, chuck wagons, dozers, back hoes, hydroponic farm equipment, aquaculture equipment,
etc.), used in the operation of a farm .
#18 - Farming Tools Farm tools, (e.g ., hoses, rakes, pitch forks, shovels, hoses, brooms, etc .) .
#19 - Mechanics Tools Mechanics tools (e.g., wrenches, air hammers, jacks, sockets, etc .) .
#20 - Electronic Data Processing Equipment Electronic data processing equipment (e .g ., computers, printers, peripheral
computer equipment, and any computer based equipment acting as a computer as defined under Section
168
of the IRS Code
of
1986,
etc.) . Bundled software is taxable and must be included .
#23 - Average Supplies The average monthly quantity of supplies normally consumed in the course of business (e .g .,
stationery, post-it notes, typewriter ribbons, computer disks, computer paper, pens, pencils, rulers, staplers, paper
clips,
medical,
and dental supplies and maintenance suppli es eetc.).
#24 - Other All Other Goods, Chattels and Effects Any other taxable personal property not previously mentioned or which does
not appear to fit into any of the other categories . (e.g . video tapes, vending machines, pinball games, video games, signs,
billboards, coffee makers, water coolers, leasehold improvements other than realty etc .).
Total Assessment - all codes #9 through #24
#25 - Penalty for failure to file as required by statute - 25% of assessment
Subtotal >
Exemption - Check box adjacent to the exemption you are claiming :
I - Mechanic's Tools - $500 value E] M - Commercial Fishing Apparatus - $500 value
I - Farming Tools - $500 value
E] I - Horses/ponies $1000 assessment per animal
All of the following exemptions require a separate application and/or certificate to be filed with the Assessor by November 3
E] J - Water Pollution or Air Pollution control equipment - Connecticut DEP certificate required - provide copy
I- Farm Machin ery $100,000 value - Exemption application M-28 required annually BY OCTOBER 31 °'
EJ G & H - Distressed Municipality/Enterprise Zone/Enterprise Corridor Zone - Exemption application M-55 required annually
Total Net Assessment
Assessor's Final Assessment Total >
Page 3
Year
Make
Model
Identification No .
Length
Weight Purchase
Price
Date
Value
Breed
A
1
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:r.'rykat
_ =s
wv* . kerseAr .Show/Pleasure/Racing .
Value
Assessment date October 1, 2009
List or Account #
Required return date November 2, 2009
Owner's Name
Address
DBA
City/State/Zip
Phone / Fax
Street location of personal property in Greenwich
E-mail
Description of business :
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