2024 Income & Expense Form

2024 
ANNUAL INCOME AND EXPENSE REPORT 
The Assessor’s Office is preparing for the next revaluation of all real property located in the Town of Waterford.  In 
order to assess your real property fairly and equitably, information regarding the property income and expenses data is 
required.  Section §12-63c of the Connecticut General Statutes requires all owners of rental real property to annually file 
this report. The information filed and furnished with this report will remain confidential in accordance with §12-
63c(b), which provides that actual rental and operating expenses shall not be a public record and is not subject to 
the provisions of Section §1-210 (Freedom of Information). 
Please complete and return the completed form to the Waterford Assessor’s Office on or before June 1, 2025. In 
accordance with Section §12-63c(d), of the Connecticut General Statutes, as amended, any owner of rental real property 
who fails to file this form or files an incomplete or false form with intent to mislead the Assessor, shall be subject to a 
penalty equal to Ten Percent (10%) of the assessed value of such property. 
GENERAL INSTRUCTIONS & DEFINITIONS -   Please complete this form for all rented or leased apartment, 
commercial, retail, industrial or combination property.  Identify the property and address and provide Annual 
information for the Calendar Year 2024. 
TYPE/USE OF LEASED SPACE: 
Indicate the type of use the leased space is being utilized for (i.e., office, retail, warehouse, restaurant, garage, etc.) 
ESC/CAM/OVERAGE: 
ESCALATION:  Amount, in dollars, of adjustment to base rent either pre-set or tied to the Inflation Index. 
CAM:  Income received from common area charges to tenant for common area maintenance, or other income received 
from the common area property. 
OVERAGE: Additional fee or rental income.  This is usually based on a percent of sales or income. 
PROPERTY EXPENSES & UTILITIES PAID BY TENANT: Indicate the property expenses & utilities the tenant is 
responsible for.  Abbreviations may be used (i.e., “RE” for real estate taxes & “E” for electricity). 
VERIFICATION OF PURCHASE PRICE:  Must be completed if the property was acquired on or after January 1, 
2024. 
WHO SHOULD FILE – All individuals and businesses receiving this form should complete and return this form to the 
Assessor’s Office.  If you believe that you are not required to fill out this form, please call the number listed above to 
discuss your special situation.  All properties which are rented or leased, including commercial, retail, industrial and 
residential properties, except “such property used for residential purposes, containing not more than six dwelling 
units and in which the owner resides”, must complete this form.  If a property is partially rented and partially owner-
occupied this report must be filed. 
HOW TO FILE – Each summary page should reflect information for a single property for the calendar year 2024.  If 
you own more than one rental property in the Town of Waterford, a separate report/form must be filed for each property.  
An income and expense report summary page and the appropriate income schedule must be completed for each rental 
property.  Income Schedule A must be filed for apartment rental property and Schedule B must be filed for all other 
rental properties.  All property owners must sign & return this form to the Waterford Assessor’s Office on or 
before June 1, 2025 to avoid a Ten Percent (10%) penalty. 
RETURN TO: 
Waterford Assessor’s Office 
15 Rope Ferry Road 
Waterford, CT 06385 
Phone: (860) 444-5820 
Fax: 
(860) 444-5819 

2024 ANNUAL INCOME AND EXPENSE REPORT SUMMARY 
   Owner: 
______________________________________________ 
Property Address:_________________________________ 
     Mailing Address: 
______________________________________________ 
Unique ID:         __________________________________ 
     City/State/Zip:    
______________________________________________ 
Check here if property is 100% Owner Occupied   
1.
Primary Property Use (Circle One) A. Apartment
B. Office
C. Retail D. Mixed Use
E. Shopping Center
F. Industrial
G. Other
2.
Gross Building Area (Including Owner-Occupied Space)   ____________Sq. Ft.
6.
Number of  Parking Spaces
 ____________________ 
3.
Net Leasable Area
 ____________Sq. Ft. 
7.
Actual Year Built
 ____________________ 
4.
Owner-Occupied Area
         ____________Sq. Ft. 
8.
Year Remodeled
 ____________________ 
5.
No. of Units
   ____________ 
INCOME – 2024 
EXPENSES – 2024 
9.
Apartment Rental (From Schedule A)
__________________ 
21. Heating/Air Conditioning
_____________________ 
10. Office Rentals (From Schedule B)
__________________ 
22. Electricity
_____________________ 
11. Retail Rentals (From Schedule B)
__________________ 
23. Other Utilities
_____________________ 
12. Mixed Rentals (From Schedule B)
__________________ 
24. Payroll (Except management, repair & decorating) ____________________
13. Shopping Center Rentals(From Schedule B)
__________________ 
25. Supplies
_____________________ 
14. Industrial Rentals (From Schedule B)
__________________ 
26. Management
_____________________ 
15. Other Rentals (From Schedule B)
__________________ 
27. Insurance
_____________________ 
16. Parking Rentals
__________________ 
28. Common Area Maintenance
_____________________ 
17. Other Property Income
__________________ 
29. Leasing Fees/Commissions/Advertising
_____________________ 
18. TOTAL POTENTIAL INCOME(Add Line 9 Through 17)  _______________
30. Legal and Accounting
_____________________ 
19. Loss Due to Vacancy and Credit
___________________ 
31. Elevator Maintenance
_______________________ 
20. EFFECTIVE ANNUAL INCOME(Line 18 Minus Line 19)______________
32. Security
_______________________ 
33. Other (Specify) ___________
      _______________________ 
34. Other (Specify) ___________
      _______________________ 
35. TOTAL EXPENSES(Add Lines 21 Through 35)_______________________
36. NET OPERATING INCOME (Ln 20 less 36)   _______________________
37.Capital Expenses
 _______________________ 
38. Real Estate Taxes
________________________ 
39. Mortgage Payment (P&I)
________________________ 
40. Depreciation
________________________ 
41. Amortization
________________________ 
Return to the Assessor on or Before JUNE 1, 2025 
I DO HEREBY DECLARE UNDER PENALTIES OF FALSE STATEMENT THAT THE FOREGOING 
INFORMATION, ACCORDING TO THE BEST OF MY KNOWLEDGE, REMEMBRANCE AND BELIEF, IS A 
COMPLETE AND TRUE STATEMENT OF ALL THE INCOME AND EXPENSES ATTRIBUTABLE TO THE 
ABOVE IDENTIFIED PROPERTY (Section §12-63c (d) of the Connecticut General Statutes 
SIGNATURE  _____________________________________________________________ 

SCHEDULE A – 2024 APARTMENT RENT SCHEDULE 
Complete this Section for Apartment Rental activity only. 
BUILDING FEATURES INCLUDED IN 
RENT 
(Please Check All That Apply) 
Heat
Garbage Disposal
Electricity
Furnished Unit
Other Utilities
Security
Air Conditioning
 Pool
Tennis Courts
Dishwasher
Stove/Refrigerator
Other Specify
SCHEDULE B - 2024 LESSEE RENT SCHEDULE 
Complete this section for all other rental activities except apartment rental. 
NAME 
OF 
TENANT 
LOCATION 
OF  
LEASED 
SPACE 
TYPE/USE 
OF  
LEASED 
SPACE 
LEASE TERM 
ANNUAL RENT 
PROPERTY EXPENSES 
& UTILITIES 
PAID BY TENANT 
START 
DATE 
END 
DATE 
LEASED 
SQ. FT. 
BASE 
RENT 
ESC/CAM/ 
OVERAGE 
TOTAL 
RENT 
RENT PER 
SQ. FT. 
TOTAL
RETURN TO ASSESSOR ON OR BEFORE JUNE 1, 2025 TO AVOID 10% PENALTY
UNIT TYPE 
NO. OF UNITS 
ROOM COUNT 
UNIT SIZE 
SQ. FT 
MONTHLY RENT 
TYPICAL 
LEASE TERM 
TOTAL 
RENTED 
ROOMS 
BATHS 
PER UNIT 
TOTAL 
EFFICIENCY
1 BEDROOM
2 BEDROOM
3 BEDROOM
4 BEDROOM
OTHER RENTABLE UNITS
OWNER/MANAGER/JANITOR OCCUPIED
SUBTOTAL 
GARAGE/PARKING
OTHER INCOME (SPECIFY) 
TOTALS

VERIFICATION OF PURCHASE  PRICE 
(Complete if the property was acquired on or after January 1, 2024)
PURCHASE PRICE   $ 
DOWN PAYMENT   $ 
DATE OF PURCHASE
(Check One) 
FIRST MORTGAGE         $ 
SECOND MORTGAGE    $ 
OTHER 
$ 
INTEREST RATE
% 
PAYMENT SCHEDULE TERM
YEARS
INTEREST RATE
% 
PAYMENT SCHEDULE TERM
YEARS
INTEREST RATE
% 
PAYMENT SCHEDULE TERM
YEARS
DID THE PURCHASE PRICE INCLUDE A PAYMENT FOR: 
Furniture? $ _____________ 
EQUIPMENT? $
OTHER (SPECIFY) $ 
(VALUE) 
(VALUE) 
(VALUE) 
WAS THE SALE BETWEEN RELATED PARTIES? (CIRCLE ONE) 
YES 
NO 
APPROXIMATE VACANCY AT DATE OF PURCHASE 
% 
WAS AN APPRAISAL USED IN THE PURCHASE OR FINANCING? 
     YES      NO 
 APPRAISED VALUE/NAME OF APPRAISER_________________________ 
PROPERTY CURRENTLY LISTED FOR SALE? (CIRCLE ONE)  
     YES      NO 
IF YES, LIST THE ASKING PRICE 
$  
 
DATE LISTED
BROKER
Remarks - Please explain any special circumstances or reasons concerning your purchase (i.e., vacancy, conditions of sale, etc.) 
RETURN TO THE ASSESSOR ON OR BEFORE JUNE 1, 2025 TO AVOID 10%  PENALTY
Fixed 
Variable 
I DO HEREBY DECLARE UNDER PENALTIES OF FALSE STATEMENT THAT THE FOREGOING INFORMATION, ACCORDING TO THE BEST OF MY 
KNOWLEDGE, REMEMBRANCE AND BELIEF, IS A COMPLETE AND TRUE STATEMENT OF ALL THE INCOME AND 
EXPENSES ATTRIBUTABLE TO THE ABOVE IDENTIFIED PROPERTY (Section §12-63c (d) of the Connecticut General Statutes). 
SIGNATURE
NAME (Print)
DATE
TITLE
TELEPHONE