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SCHEDULE OF DEDUCTION FROM ASSESSED VALUATION PERSONAL PROPERTY IN ECONOMIC REVITALIZATION AREA
State Form 52503 (R5 / 1-09) Prescribed by the Department of Local Government Finance

MARCH 1, 2009 FORM 103-ERA
PRIVACY NOTICE: The records

in this series are confidential INSTRUCTIONS: according to IC 6-1.1-35-9. 1. In order to receive a deduction, this schedule must be submitted with a timely filed Form 103-Long. 2. A separate schedule must be completed and attached to Form 103 for each approved abatement (Form SB-1 / PP). 3. Attach a copy of the applicable approved Form CF-1 to this schedule. First-time filings must also include the SB-1 and the Resolution from the designating body. 4. For any acquisitions included herein since the last assessment date, attach a list of the newly included equipment on Form 103-EL.

SECTION 1
Name of taxpayer Full address (number and street, city, state and ZIP code) County Township

TAXPAYER INFORMATION
Name of contact person E-mail address of contact person Taxing District T elephone number

(
Fax number

) )

( SECTION 2 ECONOMIC REVITALIZATION AREA INFORMATION
Resolution number

Name of body designating the Economic Revitalization Area Date designation approved (month, day, year)

Length of abatement (years) Does resolution limit dollar amount of deduction? Yes, and limit is based on equipment No Cost or Assessed value

Date designation will terminate (month, day, year)

SECTION 3

ABATED EQUIPMENT POOLING SCHEDULE

The total cost of depreciable assets is to be reported on Form 103-Long. This schedule includes only the values attributable to the new manufacturing, research and development, logistical distribution, and/or information technology equipment under abatement per the resolution and IC 6-1.112.1. Election to report cost of Depreciable Assets by federal tax year*** Yes No NOTE: See page 2 of this form for the balance of pooling schedules. * In TTV% and True Tax Value columns, circle and apply the percentage that the assessment is based upon. If, on Form 103-Long, the entry on Line 58 is equal to Line 57, use 30%. If Line 58 is equal to Line 56, Use the applicable Pool percentages. 103 Schedule A, Column C, Adjusted Cost to 3-1-09*** $ 13 From 3-2-08 to 3-1-09 14 3-2-07 to 3-1-08 15 3-2-06 to 3-1-07 16 3-2-05 to 3-1-06 17A 3-2-04 to 3-1-05 17B 3-2-03 to 3-1-04 17C 3-2-02 to 3-1-03 17D 3-2-01 to 3-1-02 17E 3-2-00 to 3-1-01 17F 3-2-99 to 3-1-00 17G 18 TOTAL POOL NUMBER 1 $ 103 Schedule A, Column C, Adjusted Cost to 3-1-09*** $ 19 From 3-2-08 to 3-1-09 20 3-2-07 to 3-1-08 21 3-2-06 to 3-1-07 22 3-2-05 to 3-1-06 23 3-2-04 to 3-1-05 24 3-2-03 to 3-1-04 25 3-2-02 to 3-1-03 26A 3-2-01 to 3-1-02 26B 3-2-00 to 3-1-01 26C 3-2-99 to 3-1-00 26D 27 TOTAL POOL NUMBER 2 $ POOL NUMBER 1 (1 TO 4 YEAR LIFE) True Tax Value Minimum Value * TTV% [per 103 or per Ratio (if applicable) (circle one) IC 6-1.1-12.1-4.5(f)]** IC 6-1.1-12.1-4.5(i) % 65% $ 65% 50% 35% 20% 20% 20% 20% 20% **65% **65% Abatement Year Percent % $ 1 1 2 3 4 5 6 7 8 9 10 --$ Abatement Year Percent 1 1 2 3 4 5 6 7 8 9 10 -% $ Deduction Claimed

30% 30%

--$ POOL NUMBER 2 (5 TO 8 YEAR LIFE) True Tax Value Minimum Value * TTV% [per 103 or per Ratio (if applicable) (circle one) IC 6-1.1-12.1-4.5(f)]** IC 6-1.1-12.1-4.5(i) % 40% $ 40% 56% 42% 32% 24% 18% 15% 15% **40% **40% --

Deduction Claimed

30% 30% $ --

--

$ $

SUB-TOTAL - POOLS 1 AND 2 (Total Lines 18 and 27. Enter to the right and on Page 2.)
Minimum Value Ratio applies if Line 57 is greater than Line 56D on page 2 of the Form 103 - Long. The ratio is Line 57 divided by Line 56D.

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SECTION 3 (continued) 103 Schedule A, Column C, Adjusted Cost 28 29 30 31 32 33 34 35 36 37 38 40 From to 3-1-09*** $ 3-2-08 to 3-1-09 3-2-07 to 3-1-08 3-2-06 to 3-1-07 3-2-05 to 3-1-06 3-2-04 to 3-1-05 3-2-03 to 3-1-04 3-2-02 to 3-1-03 3-2-01 to 3-1-02 3-2-00 to 3-1-01 3-2-99 to 3-1-00 TOTAL POOL NUMBER 3 $

ABATED EQUIPMENT POOLING SCHEDULE POOL NUMBER 3 (9 TO 12 YEAR LIFE) Minimum Value True Tax Value * TTV% [per 103 or per Ratio (if applicable) (circle one) IC 6-1.1-12.1-4.5(f)]** IC 6-1.1-12.1-4.5(i) % 40% $ 40% 60% 55% 45% 37% 30% 25% 20% **40% **40%

Abatement Year Percent % $ 1 1 2 3 4 5 6 7 8 9 10 --

Deduction Claimed

30% 30%

41 42 43 44 45 46 47 48 49 50 51 55

--$ POOL NUMBER 4 (13 YEAR AND LONGER LIVES) Minimum Value True Tax Value 103 Schedule A, * TTV% [per 103 or per Ratio (if applicable) Column C, (circle one) IC 6-1.1-12.1-4.5(f)]** IC 6-1.1-12.1-4.5(i) Adjusted Cost From to 3-1-09*** $ % 40% 30% $ 3-2-08 to 3-1-09 40% 30% 3-2-07 to 3-1-08 60% 30% 3-2-06 to 3-1-07 63% 30% 3-2-05 to 3-1-06 54% 30% 3-2-04 to 3-1-05 46% 30% 3-2-03 to 3-1-04 40% 30% 3-2-02 to 3-1-03 34% 30% 3-2-01 to 3-1-02 29% 30% 3-2-00 to 3-1-01 **40% 30% 3-2-99 to 3-1-00 **40% 30% TOTAL POOL NUMBER 4 $ --$

--

$ Deduction Claimed

Abatement Year Percent 1 1 2 3 4 5 6 7 8 9 10 -% $

--

$ $

SUB-TOTAL - POOLS 3 AND 4 (Total Lines 40 and 55. Enter to the right and below.) SPECIAL TOOLING Round all figures to the nearest $1. Report only the cost of abated special tools, dies, jigs, etc. (50 IAC 4.2-6-2) S1 From to 3-1-09*** S2 3-2-08 to 3-1-09 S3 3-2-07 to 3-1-08 S4 3-2-06 to 3-1-07 S5 3-2-05 to 3-1-06 S6 3-2-04 to 3-1-05 S7 3-2-03 to 3-1-04 S8 3-2-02 to 3-1-03 S9 3-2-01 to 3-1-02 S10 3-2-00 to 3-1-01 S11 3-2-99 to 3-1-00 S12 TOTAL SPECIAL TOOLING $
[included on Form 103-T or per IC 6-1.1-12.1-4.5(f)]**

True Tax Value

Abatement Year Percent 1 1 2 3 4 5 6 7 8 9 10 -% $

Deduction Claimed

30% 30% 3% 3% 3% 3% 3% 3% 3% **30% **30%

The Minimum Value Ratio Is Not Applicable To Special Tooling

$

--

--

$ $

SUB-TOTAL POOLS 1 AND 2 (from Page 1) SUB-TOTAL POOLS 3 AND 4 (from above) SUB-TOTAL SPECIAL TOOLING (from above - Line S12) TOTAL ALL POOLS AND SPECIAL TOOLING LIMIT ON AMOUNT OF ABATEMENT STATED IN RESOLUTION AMOUNT OF DEDUCTION CLAIMED - Lesser of resolution limit on abatement or total all pools.
(Carry deduction forward to the Summary Section on Page 1 of the Form 103.)

Cost

$

AV

$ $ $

Obsolescence claimed on Form 106?

Yes

No

NOTE: If obsolescence is claimed on depreciable assets, the applicable adjustment must be taken on the Abatement Deduction being claimed. Show calculations on Form 106. Line numbers reference pooling schedule line numbers on Form 103 - additions (alphas) and deleted numbers accommodate the ten (10) year abatement limitation. *** If taxpayer elects to report cost on a federal tax year basis, assets acquired from the end of the prior federal tax year to March 1 are reported on the first line.

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