Tax Year: 2014
Owner Name: _______________________________________
Address: ___________________________________________
Assessment Code: ___________________________________
County: ____________________________________________
Heavy Equipment Instructions
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Provide a description of each item including options, e.g., 4-wheel drive, power steering, EROPs, etc.
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Report attachments, e.g., bucket, blade, etc. Use separate lines if you need more room.
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Complete each column that applies.
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Specify the size, number of rows, length, width, etc.
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The year new indicates the year manufactured. If you’re unsure, please provide your best estimate.
Use the Heavy Equipment table to report the following types of equipment.
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Air Equipment / Asphalt Finisher / Crushing Equipment / Ditcher / Loader /Wheel Tractor / Crawler Loader / Crawler Tractor / Motor Scraper / Grader /
Tractor Loader-Backhoe / Skid Steer Loader / Crane (mechanical excavator) / Crane (truck) / Crane (tower) / Crane (hydraulic) / Excavator (hydraulic) /
Excavator (wheel) / Bucket / Pile Driving Equipment / Belt Loader / Concrete Equipment / Sweeper and Broom / Generator / Road Maintenance Equipment
/ Personnel and Maintenance Lifts / Off-Highway Hauling Units / Truck (Rear Dump) / Truck (Chassis Cab) / Trailer (Allied Attachment) / Haul Units
(indicate rear or bottom dump) / Haul Units (coal hauler) / Prime Movers / Trailer ( indicate end, bottom or side dump) / Trailer (coal hauler) / Trailer (water)
/ Trailer (equipment) / Tires / Lift Truck / Tamper / Screen Plant / Fork Lift / Pallet Truck / Backhoe / Dozer / Hoist / Drills / Attachments / Welder / Batch
Plant / Dewaterer / Boiler / Fertilizer Spreader / Fertilizer Tender / Nurse Tank / Paver / Roller / Light Plant / Dragline – Electric Shovel / Blade / Snow
Blade / Grapple / Ripper – Scarifi er / Locomotive / Trackmobile / Log Stacker / Log Loader / Crane / Straddle Carrier / Personnel Carrier / Skidder / Auger /
Fertilizer Applicator / Fertilizer Sprayer / Scale / Silo / Tank / Wash Plant/ Bandwagon / Miscellaneous Heavy Equipment
Heavy Equipment
Write in the physical address of the equipment in the table header.
Mark an X in the Delete column and draw a line through the description of items you no longer own.
Mark an X in the Add column and enter the information for items you have acquired.
Mark an X in the SM column if you have purchased a Special Mobile permit for the current year.
Mark an X in the Personal Use Only column if the item is used for your personal domestic use only.
Enter quantity as of January 1, 2014.
Physical Address:
For dept
Acquired
For dept
use only
Year
Company ID
Description/Options
Make
Model or Size
Serial number SM
use only
– Tbl/
New
number
Year
Cost
Sb
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