Form Atd25 - Commercial / Agricultural/ Industrial Personal Property - Owned Declaration Schedule Page 2

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Form ATD25
State of Wyoming,
Page 2 of 2
COMMERCIAL / AGRICULTURAL/ INDUSTRIAL
PERSONAL PROPERTY—OWNED
DECLARATION SCHEDULE
County Number
Parcel #
Act Number
Personal Prop. Type
DO NOT USE - FOR ASSESSORS USE ONLY
Date received:
By:
Name and address of personal property listed here: (please make any corrections here)
Please indicate location of personal property: (please make any changes here)
PERSONAL PROPERTY YOU LEASE, LOAN, OR RENT LISTING: Please list only those items you are not responsible for here.
NAICS CODE:
( please indicate any changes by lining out the items that have been removed and filling in the new items purchased)
_______________
Owner and Address of Leased
Property Description
Cost of Leased Property
Term (From - To)
Annual Rent
Property
W.S. 39-13-107 (a)(i) I...the owner of (or agent, etc., as the case may be) do solemnly swear or affirm that the above and foregoing listed property is a full, true, correct
and complete list of all property owned by me or under my control as agent or otherwise, and that I have not failed or neglected to list for taxation for the year_____,
all property of which I am the owner of or of which I have control as agent, guardian, administrator or otherwise, in the county of________, State of Wyoming and that
I have not connived at any violation or evasion of the requirements of law in relation to the assessment of property for taxation. W.S. 18-3-205(b) Any person who
fails to return any taxable property owned by him or under his control is guilty of a misdemeanor and upon conviction shall be fined not exceeding five hundred dollars
($500.00), imprisoned in the county jail not exceeding ninety (90) days, or both.
Type or print your name here: _______________________________________________________________________________________________________
Signature of owner/agent___________________________________________________ Title ________________________Date _______________________
Telephone number ____________________________ Fax Number ___________________________________ Email: _______________________________

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