FARM MACHINERY, HORSES OR PONIES
This application for exemption on all farm machinery, except motor vehicles as defined in Section 14-
1, to an assessment of $100,000, ponies or horses which are actually and exclusively used in farming,
within the provisions of Section 12-91 as amended by PA 14-33 section 2 of the General Statutes
MUST BE FILED ANNUALLY BY NOVEMBER 4
ST
* with the assessor or board of assessors of the
municipality in which the property is located. Failure to file this application within the time limit
prescribed shall be considered a waiver of the right to such exemption for the assessment year.
*2019 filing date is Monday, November 4, 2019.
Owner/Farme
Mailing Address Phone
Location of farm machinery and ponies or horses
Have you filed, or do you intend to file, any application for exemption as
provided under the above statute, in this or any other town or city, as trustee, as
an individual farmer, or as a member of a group of farmers, partnership or family
corporation, other than under the ownership contained in this application?
YES NO
Do you derive at least $15,000 in gross sales, or did you incur at least $15,000
in expenses related to such farming operation during the previous calendar
ear?
YES NO
Are the horses and ponies, and/or farm machinery kept within the State of
Connecticut?
YES NO
If yes, list town(s):
Machinery
Make
ea
Model Description of use in farmin
I DO HEREBY declare in accordance with § 12-91 of the Connecticut General Statutes under penalty
of perjury that the statements herein made by me are true according to the best of my knowledge and
belief.
Date: Signed: (owner(s) or trustee(s))
X
Subscribed and Sworn
f
r
m
:
X
Date: My commission expires
M-28 Revised August 2017
Approved by Commissioner of Agriculture
