Partnership or Joint Venture Sole Proprietorship Corporation Estate or Trust
Other (describe): _______________________________________________________________________________
BUSINESS TANGIBLE
PERSONAL PROPERTY RETURN
State Form 11274 (R38 / 11-19)
Prescribed by the Department of Local Government Finance
Name of taxpayer
Name under which business is conducted
Address where property is located (number and street, city, state, and ZIP code)
Nature of business
Name and address to which Assessment and Tax Notice are to be mailed (If different than above)
Federal identification number **
DLGF taxing district number
DLGF taxing district name
Township
County
Signature of authorized person
Printed name of authorized person
Signature of person preparing return, if different than authorized person
Printed name and contact information of person preparing return
Under penalties of perjury, I hereby certify that this return (including any accompanying schedules and statements), to the best of my knowledge and
belief, is true, correct, and complete; if applicable, reports all tangible personal property subject to taxation owned, held, possessed or controlled by the
named taxpayer in the stated township or taxing district on the assessment date, as required by law; and is prepared in accordance with IC 6-1.1 et seq.,
as amended, and regulations promulgated with respect thereto.
SIGNATURE AND VERIFICATION
$
$
Date (month, day, year)
Telephone number
( )
Yes No
2. Location of accounting records
NAICS Code number *
Schedule A - Personal Property +
Final Assessed Value =
SUMMARY (Round all numbers to nearest ten dollars) REPORTED BY TAXPAYER CHANGE BY ASSESSOR CHANGE BY COUNTY BOARD
$
$
$
$
* NAICS - North American Industry Classification System - complete list of codes may be found at www.census.gov.
NOTE: The NAICS Code Number appears on your federal income tax return.
** An individual using his Social Security number as the Federal Identification number is only required to provide the last four (4) digits of that number per IC 4-1-10-3.
Page 1 of 2
JANUARY 1, 2020
For Assessor's Use Only
6. Did you own, hold, possess or control any leased, rented or other depreciable personal property on January 1?
If yes, file the Form 103-N or 103-O (See 50 IAC 4.2-8-3 and 4).
Note: Failure to properly disclose lease information may result in a double assessment.
Title
Contact e-mail address
INSTRUCTIONS:
1. Please type or print.
2. This form must be filed with the Township Assessor, if any, or the County Assessor of the county in which the property is located not later than May 15, 2020,
unless an extension of up to thirty (30) days is granted in writing. Contact information for the Assessor is available at http://www.in.gov/dlgf/2440.htm.
3. A Form 104 must be filed with this return.
NOTE: You must use Form 103-Long if:
a. You are a manufacturer or processor;
b. Your business personal property assessment is $150,000 or more;
c. You wish to claim any exemptions or deductions (other than the enterprise zone credit); or
d. You are claiming any special adjustments such as equipment not placed in service, special tooling,
permanently retired equipment or abnormal obsolescence.
FORM 103 - SHORT
PRIVACY NOTICE
This form contains information
confidential pursuant to IC 6-1.1-35-9.
SECTION IV
SECTION III
4. Do you have other locations in Indiana?
1. Federal income tax year ends
3. Form of business
Retail merchant’s certificate number
SECTION II
SECTION I
NOTE: For taxpayers with less than $40,000 in acquisition costs to report within the county, legislation was passed in 2019 which exempts this property. If
you are declaring this exemption, check this box, enter the total acquisition cost of your personal property in the county, and complete only sections I, II, and
IV of this form. If you are declaring this exemption through this form, you also need to file a Form 104.
$ ________________________
RETURN THIS FORM TO THE APPLICABLE ASSESSOR BY MAY 15, 2020.
An exemption granted under IC 6-1.1-10 or any other statute supersedes this exemption. In other words, a taxpayer whose personal property is exempt
because the taxpayer applied for and was granted an exemption by the county must follow all applicable procedures for the approved exemption, which
may include fully completing the personal property return.
5. If property is in more than one location, what is the address for the location where the sum of acquisition costs for the property is greatest?
Yes No
Reset Form
Fully depreciated assets must be included in the total cost to be reported in Schedule A above.
YEAR OF ACQUISITION
COLUMN A COLUMN B
LINE
TOTAL COST
T. T. V. %
TRUE TAX VALUE
1-2-19 To 1-1-20
1-2-18 To 1-1-19
1-2-17 To 1-1-18
1-2-16 To 1-1-17
3-2-15 To 1-1-16
3-2-14 To 3-1-15
3-2-13 To 3-1-14
3-2-12 To 3-1-13
3-2-11 To 3-1-12
3-2-10 To 3-1-11
Prior To 3-2-10
TOTALS
30% of line 12, Column A
CONFIDENTIAL
SCHEDULE A
JANUARY 1, 2020
FORM 103-SHORT FORM
See 50 IAC 4.2-4
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Line 14 must be the greater of Line 12, Column B or Line 13 (See 50 IAC 4.2- 4-9)
Total True Tax Value of Depreciable Personal Property (To Summary on reverse side)
$
$
40
60
55
45
37
30
25
20
16
12
10
$
$
YEAR OF ACQUISITION
DEPRECIABLE PERSONAL PROPERTY
Page 2 of 2
Filing Basics:
For the assessment date of January 1, 2020, IC 6-1.1-3-7.2 was amended to allow an exemption for taxpayers with less than $40,000 in acquisition
costs to be reported within a county. Failure to timely file a personal property tax return with the applicable assessor declaring the exemption will
result in a $25 penalty. (IC 6-1.1-37-7) For more information, refer to this link: http://www.in.gov/dlgf/7576.htm.
To locate contact information for the various county offices (Assessor, Auditor, and Treasurer), locate forms, and learn more about Indiana’s personal
property tax system, go to www.in.gov/dlgf. Contact information for the Assessor is available at http://www.in.gov/dlgf/2440.htm.
Taxpayers may request up to a thirty (30) day extension of time to file their return. The written request should be sent to the Assessor before
the filing deadline of May 15, 2020, and should include a reason for the request. The Assessor may, at their discretion, approve or disapprove
the request in writing.
Personal property must be assessed in each taxing district where property has a tax situs.
Inventory located in the State of Indiana is exempt and is not required to be reported per IC 6-1.1-1-11(b)(3).
It is the responsibility of the taxpayer to obtain forms from the Assessor and file a timely return. The forms are also available on-line at the
department’s website, www.in.gov/dlgf.
Taxpayers may consider the ease of filing this short form versus the possible tax savings by filing Form 103-Long before choosing the form they
wish to file.
If you hold, possess, or control not-owned personal property on the assessment date, you have a liability for the taxes imposed for that year
unless you establish that the property is to be assessed to the owner. This is done by completing a Form 103-N, attaching it to the Form 103-Short,
and filing it with the Assessor. A taxpayer declaring the exemption on page one of this form may, as deemed necessary by the applicable assessor,
need to file Form 103-O or 103-N, as applicable, to verify that he is the appropriate taxpayer to claim the exemption.
NOTE: Failure to properly disclose lease information may result in a double assessment. (IC 6-1.1-2-4(a))
Taxpayers who discover an error was made on their original timely filed personal property tax return have the right to file an amended return. The
amended return must be filed within twelve (12) months of the due date or the extended due date (if up to a thirty (30) day extension was granted)
of their original return.
Information of Not-Owned Personal Property which is to be assessed to the Owner
NOTE: This form is for the reporting of two or less Operating Leases. For all other leases, the Form 103-N (for the lessee) and the Form 103-O (for the
lessor) should be utilized. For more information on the reporting of leased equipment, refer to 50 IAC 4.2-8. Failure to properly disclose lease information
may result in a double assessment.
Name and Address
of Owner
Location of
Property
Date of Lease
(month, day, year)
Model Number
and Description
Quantity
Cost,
if Known
SECTION V
SECTION VI