State Of Wyoming Fire Suppression Exemption Application Form Page 4

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(PART 1 & 2 – Tax Payer & Representative Identification)
Self Explanatory
(PART 3 – Plant & Property Location)
Describe the location and nature of the operating property where the fire suppression equipment is
operated. Include physical address and/or legal description of the property, county, tax district and
date placed into service.
(PART 4 – Exemption Request)
Detailed description of the individual facility, device, equipment, etc. being considered for
exemption (extinguisher, fire engine, sprinkler system, etc.). One item per application, do not
combine multiple pieces of equipment on an application. Include Make, Model, and/or Serial
Number (or any other identifiers) and date placed into operations.
(PART 5 – Installed Cost)
Self Explanatory
(PART 6 – Construction Work In Progress)
Provide any supplemental detail, including cost information for fire suppression equipment included
within Construction Work In Progress accounts.

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