Free 22667.FH11 - Indiana

RETURN OF SPECIAL TOOLS
State Form 22667 (R8 / 1-06) Prescribed by the Department of Local Government Finance

FORM 103-T

PRIVACY NOTICE
The records in this series are confidential according to IC 6-1.1-35-9.

MARCH 1, 20 ______
For assessing officials only

INSTRUCTIONS: Attach and file with Form 103 Long.
Name of owner (please print or type) Address where property is located (number and street, city, state and ZIP code) County DLGF taxing district number

SECTION I

REPORT OWNED SPECIAL TOOLS ON THIS SIDE INCLUDE - TOOLS, DIES, JIGS, PATTERNS, FIXTURES, ETC., OWNED

SCHEDULE I $ TRUE TAX VALUE

LINE Round all figures to the nearest dollar. Total Cost of special tools, dies, jigs, etc. (50 IAC 4.2-6-2) 1 2 3 4 NOTE: Divide Total Cost on Line (1) above into two categories as noted below. CATEGORY I Total Cost (Acquisitions since last assessment date) CATEGORY II Total Cost (Acquisitions prior to last assessment date) Total True Tax Value, Special Tools - to Form 103, Section A, Line 60 $ $ X 30% = X 3% =

$ $ $

SECTION II - ASSESSED TO OWNER ON FORM 103 Information return of all special tools owned and reported for assessment on Form 103 as of March 1 of the current assessment year by this taxpayer but which were held, possessed or controlled by another person. (Attach list if necessary.)
NAME AND ADDRESS OF PERSON POSSESSING PROPERTY LOCATION OF PROPERTY DATE OF MANUFACTURE DESCRIPTION DATE DELV'D TO POSSESSOR QUANTITY COST PER 50 IAC 4.2

TOTAL INSTRUCTIONS: Line (1) Total Cost of all special tools is defined in 50 IAC 4.2-6-2 (b).

FORM 103-T

SCHEDULE II REPORT SPECIAL TOOLS POSSESSED, BUT NOT OWNED ON THIS SIDE INCLUDE - TOOLS, DIES, JIGS, PATTERNS, FIXTURES, ETC., NOT OWNED

MARCH 1, 20 ______

Name of person in possession of property (please print or type) Address where property is located (number and street, city, state and ZIP code)

County DLGF taxing district number

LINE Round all figures to the nearest dollar. Total Cost of special tools, dies, jigs, etc. not owned (if known) (50 IAC 4.2-6-2) 1 ASSESSED TO OWNER ON FORM 103

$

Information return of all special tools not owned and reported for assessment on Form 103 as of March 1 of the current assessment year by the owner but which were held, possessed or controlled by this taxpayer. (Attach list if necessary)
NAME AND ADDRESS OF OWNER LOCATION OF PROPERTY DATE OF MANUFACTURE DESCRIPTION DATE ACQUIRED QUANTITY COST PER 50 IAC 4.2

TOTAL

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