Personal Property Declaration - Short form 2023 GL

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Connecticut 
2023 Declaration of Personal Property – Short Form 
Who Should File: All owners of taxable personal property. If you no 
longer own the above noted business or personal property assessed in your 
name last year, you need only to complete the AFFIDAVIT OF BUSINESS 
CLOSING OR MOVE OF BUSINESS OR SALE OF BUSINESS below and return this 
declaration to the Assessor. If you do not, the Assessor must assume that 
you are still operating the business or still own and have failed to declare 
your taxable personal property. 
Complete:  Complete the entire declaration. Writing “Same as last year” is 
not acceptable.  Do not forget the DETAILED LISTING OF DISPOSED ASSETS 
REPORT (page 2) and the LESSEE’S LISTING REPORT (page 4). 
Signature Required: The owners shall sign the DECLARATION OF 
PERSONAL PROPERTY AFFIDAVIT (page 4). The owner’s agent may sign the 
declaration, in which case the declaration must be duly sworn to or 
notarized. 
Extension: The Assessor may grant a filing extension for good cause 
(CGS §12-42).  If a request for an extension is needed, you need to request 
the filing extension in writing on or before November 1, 2023 (PA 19-
210). 
 
Penalty for late filing – Failure to file timely will result in a penalty equal to 
25% of the assessment of the personal property.  This declaration must be 
filed or postmarked (as defined in C.G.S. Sec. 1-2a) no later than: 
 
 
Wednesday, November 1, 2023 
 
 
 
Check Off List: 
 
 
 Read instructions 
 
 
 Complete appropriate sections 
 
 
 Complete exemption applications 
 
 
 Complete disposed asset report 
 
 
 Corporations complete all of page 3 
 
 
 Make a copy for your records 
 
 
 Sign, date & witness as required on page 4 
 
 
 Return by November 1, 2023 
 
AFFIDAVIT OF BUSINESS TERMINATION OR MOVE OR SALE OF BUSINESS OR PROPERTY 
I 
 
of  
at  
 
 
Business or property owners name 
 
Business Name (if applicable) 
 
Street location in «Town» 
With regards to said business or property I do so certify that on 
 
 
Said business or property was (Please   appropriate box): 
 
 
 
Date  
 SOLD TO: 
 
 
 
 
 
Name 
 
Address 
 MOVED TO: 
 
 
 
 
 
City/Town and State to where business or property  was moved 
 
Address 
 TERMINATED: 
Attach Bill of Sale or Letter of dissolution to this form and return it with this affidavit to the Assessor’s office 
 
The signer is made aware that the penalty for making a false affidavit is a $500.00 fine or imprisonment for one year or both. 
 
 
 
 
 
 
Signature 
Print name 
 
This form may NOT be used by utility companies, telecommunication companies, lessors, 
or persons claiming manufacturing machinery and equipment (Codes 10 or 13) 
 
 

 
 
 
 
Detailed Listing of Disposed Assets Report– If you disposed of, sold, or transferred a portion of the property included in last year’s filing,  
                                                                                         complete the following.  DO NOT INCLUDE DISPOSALS IN TAXABLE PROPERTY INFORMATION      
Date Removed 
Code # 
Description of Item 
Date Acquired 
Acquisition Cost 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Detailed Listing of Assets Orig Value ≤ $250  
Pursuant to CGS 12-81(79) – Listing of assets purchased prior to 10/1/13 with a value of ≤ $250 
Description of Item 
Date Acquired 
Acquisition Cost 
 
 
 
 
 
 
 
 
 
 
 
Page 2 
 
 
2023 PERSONAL PROPERTY DECLARATION – SHORT FORM 
Commercial and financial information is not open to public inspection. 
TAXABLE PROPERTY INFORMATION   Give actual acquisition costs including any additional 
charges for transportation and installation by year for each type of property described.          
COPY AND ATTACH ADDITIONAL SHEETS IF NEEDED     
Circle 
One 
#12 – Commercial Fishing Apparatus      or 
#17 – Farm  machinery 
 
Circle 
One 
#18 – Farm Tools            or 
#19 – Mechanics Tools                                           
 
Assessor’s 
Use Only 
Year 
Ending 
Original cost, installation  
& transportation 
% 
Good 
Depreciated Value 
 
Year 
Ending 
Original cost, installation 
& transportation 
% 
Good 
Depreciated Value 
 
 
 
 
 
10-1-23 
 
95% 
 
 
10-1-23 
 
95% 
 
 
 
 
10-1-22 
 
90% 
 
 
10-1-22 
 
90% 
 
 
 
 
10-1-21 
 
80% 
 
 
10-1-21 
 
80% 
 
 
#12 
 
10-1-20 
 
70% 
 
 
10-1-20 
 
70% 
 
 
 
 
10-1-19 
 
60% 
 
 
10-1-19 
 
60% 
 
 
#17 
 
10-1-18 
 
50% 
 
 
10-1-18 
 
50% 
 
 
 
 
10-1-17 
 
40% 
 
 
10-1-17 
 
40% 
 
 
#18 
 
Prior Yrs 
 
30% 
 
 
Prior Yrs 
 
30% 
 
 
 
 
Total 
 
Total 
 
 
Total 
 
Total 
 
 
#19 
 
#16 – Furniture, fixtures and equipment 
 
 # 20 -- Electronic data processing equipment 
 
 
Year 
Ending 
Original cost, installation  
& transportation 
% 
Good 
Depreciated Value 
 
Year 
Ending 
Original cost, installation 
& transportation 
% 
Good 
Depreciated Value 
 
 
 
 
 
10-1-23 
 
95% 
 
 
10-1-23 
 
95% 
 
 
 
 
10-1-22 
 
90% 
 
 
10-1-22 
 
80% 
 
 
 
 
10-1-21 
 
80% 
 
 
10-1-21 
 
60% 
 
 
 
 
10-1-20 
 
70% 
 
 
10-1-20 
 
40% 
 
 
 
 
10-1-19 
 
60% 
 
 
Prior Yrs 
 
20% 
 
 
 
 
10-1-18 
 
50% 
 
 
Total 
 
Total 
 
 
 
 
10-1-17 
 
40% 
 
 
In accordance with Section 168 IRS Codes 
Computers Only 
 
#16 
 
Prior Yrs 
 
30% 
 
 
 
 
 
Total 
 
Total 
 
 
 
#20 
 
# 23 – Expensed supplies  The average is the total amount ex-
pended on supplies since October 1, 2022 divided by the number 
of months in business since October 1, 2022 
Year 
Ending 
Total Expended 
# of 
Mos. 
Average Monthly 
 
 
 
 
 
 
10-1-23 
 
 
 
 
#23 
 
#24a – Other Goods - including leasehold improvements 
 
#24b -- Rental Entertainment Medium 
 
 
Year 
Ending 
Original cost, installation  
& transportation 
% 
Good 
Depreciated Value 
 
Year 
Ending 
Original cost, installation 
& transportation 
% 
Good 
Depreciated Value 
 
 
 
10-1-23 
 
95% 
 
 
10-1-23 
 
95% 
 
 
 
 
10-1-22 
 
90% 
 
 
10-1-22 
 
80% 
 
 
 
 
10-1-21 
 
80% 
 
 
10-1-21 
 
60% 
 
 
 
 
10-1-20 
 
70% 
 
 
10-1-20 
 
40% 
 
 
 
 
10-1-19 
 
60% 
 
 
Prior Yrs 
 
20% 
 
 
 
 
10-1-18 
 
50% 
 
 
Total 
 
Total 
 
 
 
 
10-1-17 
 
40% 
 
 
 
# of video tapes 
 
# of DVD movies 
 
 
 
Prior Yrs 
 
30% 
 
 
 
# of music CD’s 
 
# of video games 
 
 
 
Total 
 
Total 
 
 
 
24a  and 24b  Total 
 
 
#24 
 

 
2023 PERSONAL PROPERTY DECLARATION – SHORT FORM SUMMARY SHEET 
 Commercial and financial information is not open to public inspection 
 
 
Assessment date October 1, 2023
List or Account # 
 
Required return date November 1, 2023
Owner’s Name 
 
 
Address 
 
 
DBA 
City/State/Zip 
 
 
 
Phone / Fax 
/ 
 
Street location of personal property in «Town» 
E-mail 
 
 
 
 
 
Description of business: 
Type of ownership:  Corporation  Partnership   LLC  Sole Proprietor  Other-Describe 
 
Type of business:   Manufacturer   Wholesale   Service   Profession   Retail/Mercantile   Tradesman   Other 
IRS Business Activity Code  
Square footage 
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. 
ASSESSOR’S 
USE ONLY 
Year 
Make 
Model 
Identification No. 
Length Weight 
Purchase 
Price 
Date 
Value 
 
Code ASSESSMENTS 
 
 
 
 
 
 
 
 
 
 
#9 
 
 
 
 
 
 
 
 
 
 
 
#9 
 
 
 
 
 
 
 
 
 
 
 
#9 
 
#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 by the Assessor. 
 
 
Breed 
Age 
Registered 
Sex 
Quality:  
Breeding/Show/Pleasure/Racing 
Value 
 
 
 
 
 
 
 
 
 
 
#11 
 
 
 
 
 
 
 
#11 
 
 
 
 
 
 
 
#11 
#14 Mobile Manufactured Homes if not currently assessed as real estate 
 
 
Year 
Make 
Model 
Identification No. 
Length 
Width 
Bedrooms 
Baths 
Value 
 
 
 
 
 
 
 
 
 
 
 
 
 
#14 
 
Property Code and Description 
Net Depreciated 
Value From page 2 
 
 
#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. 
 
 
#12 
 
#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. 
 
 
 
#16 
 
#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. 
 
 
#17 
 
#18 - Farming Tools Farm tools, (e.g., hoes, rakes, pitch forks, shovels, hoses, brooms, etc.). 
 
 
#18 
 
#19 - Mechanics Tools Mechanics tools (e.g., wrenches, air hammers, jacks, sockets, etc.). 
 
 
#19 
 
#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. 
 
 
#20 
 
#23 - Average Supplies The average monthly quantity of supplies normally consumed in the course of business (e.g., 
stationery, post-it notes, toner, computer  disks, computer paper, pens, pencils, rulers, staplers, paper clips,  medical and dental 
supplies and maintenance supplies, etc.). 
 
 
#23 
 
#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 and construction in progress (CIP). 
 
 
#24 
 
Total Assessment – all codes #9 through #24                                                                     Subtotal > 
 
 
 
#25 – Penalty for failure to file as required by statute – 25% of assessment 
 
 
#25 
 
Exemption  - Check box adjacent to the exemption you are claiming: 
 
 
 
 
 I – Farming Tools - $500 value     I – Horses/ponies $1000 assessment per animal    I – Mechanic’s Tools - $500 value 
 
 
 
 K – Municipal Leased      M – Commercial Fishing Apparatus - $500 value 
 
 
 
All of the following exemptions require a separate application and/or certificate to be filed with the Assessor by the required return date 
 
 
 G & H – Distressed Municipality/Enterprise Zone/Enterprise Corridor Zone  - Exemption application M-55 required annually 
 I – Farm Machinery $100,000 assessment  - Exemption application  M-28 required annually 
 J – Water Pollution or Air Pollution control equipment – Connecticut DEEP certificate required – provide copy 
 
 
 
Total Net Assessment 
Assessor’s Final Assessment Total >  
 
 
Page 3 
 

 
 
LESSEE’S LISTING REPORT Lessee’s Name ________________________________________ Pursuant to Connecticut General Statutes §12-
57a all leased, borrowed, consigned, loaned, rented, or stored personal property not owned by you but in your possession as of the assessment date must be included on this form. 
Failure to declare, in the form and manner as herein prescribed, shall result in the presumption of ownership and subsequent tax liability plus penalties.  Property you do not lease 
that may be in your possession and must be reported includes (but is not limited to) dumpsters, gas/propane tanks, vending machines, water coolers, coffee machines. 
COPY AND ATTACH ADDITIONAL SHEETS IF NEEDED 
Yes 
 
No 
 
Did you dispose of any leased items that were in your possession on  
October 1, 2022?  If yes, enter a description of the property and the  
date of disposition in the space to the right. 
 
 
 
 
Did you acquire any of the leased items that were in your possession 
on October 1, 2022?  If yes, indicate previous lessor, item(s) and 
date(s) acquired in the space to the right. 
 
 
 
 
 
 Is the cost of any of the equipment listed below declared anywhere else on this declaration?  If yes, note year in the ‘Year Included’ row and list  
cost in the ‘Acquisition Cost’ row. 
 
Lease #1 
Lease #2 
Lease #3 
Name of Lessor 
 
 
 
Lessor’s address 
 
 
 
Lease Number 
 
 
 
Item description / Model # 
 
 
 
Serial # 
 
 
 
Year of manufacture 
 
 
 
Capital Lease 
Yes   No  
Yes   No  
Yes   No  
Lease Term – Beginning/End 
 
 
 
Monthly rent 
 
 
 
Acquisition Cost 
 
 
 
Year Included 
 
 
 
 
 
 
DECLARATION OF PERSONAL PROPERTY AFFIDAVIT 
THIS FORM MUST BE SIGNED (AND IN SOME CASES WITNESSED) BEFORE IT MAY BE FILED WITH THE ASSESSOR. 
AVOID PENALTY – IMPROPERLY SIGNED DECLARATIONS REQUIRE A 25% PENALTY 
COMPLETE SECTION A OR SECTION B 
 
Section A 
 
 
OWNER:  I DO HEREBY declare under penalty of false statement that all sections of this declaration have been 
completed according to the best of my knowledge, remembrance, and belief; that it is a true statement of all my personal 
property liable to taxation; and that I have not conveyed or temporarily disposed of any estate for the purpose of evading 
the laws relating to the assessment and collection of taxes as per Connecticut General Statutes §12-49. 
 
 
CHECK ONE 
 
OWNER 
 
PARTNER 
 
 
 
 
CORPORATE OFFICER 
 
MEMBER 
 
 
 
Signature 
 
Dated 
 
 
 
 
 
Signature/Title 
 
 
 
 
Print or type name 
 
 
 
Section B 
 
 
AGENT  I DO HEREBY declare under oath that I have been duly appointed agent for the owner of the property listed herein and that I have 
full authority and knowledge sufficient to file a proper declaration for him in accord with the provisions of §12-50 C.G.S. 
 
 
Agent’s 
Signature 
 
Dated 
 
 
 
 
 
Agent’s Signature /Title 
 
 
 
 
Print or type agent’s name 
 
 
 
AGENT SIGNATURE MUST BE WITNESSED 
 
 
Witness of agent’s sworn statement 
 
 
 
 
 
 
Subscribed and sworn to before me - 
 
Dated 
 
 
 
 
 
Circle one:  Assessor or staff member, Town Clerk, Justice of the Peace, Notary or Commissioner of Superior 
Court 
 
 
 
 
 
 
 
 
 
 
 
 
The Personal Property Declaration must be signed above and delivered to the Assessor or postmarked (as defined in C.G.S. Sec. 
1-2a) by Wednesday, November 1, 2023 – a 25% Penalty required for failure to file as required. 
 
Page 4