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