State of Wyoming
Fire Suppression Exemption Application Form
PART 1 – Tax Payer Identification
1. Company Name/Applicant:
2. Address:
3. Primary SIC / NAICS Code:
4. City, State:
5. Zip Code:
PART 2 – Company Representative
6. Name:
7. Position/Title:
8. E-Mail Address:
9. Phone: 10. Fax:
PART 3 – Plant / Property Location
11. Plant Name / Location: (
Address and Legal Description)
12. Date Plant Placed In Operations:
13. Operations Conducted:
(Describe Property, Facility, or Equipment)
14. County: 15. Tax District: 16. Assessing / Valuation Jurisdiction:
Local County Assessment
PART 4 – Exemption Request
17. Fire Suppression Facility, Device, Method, Machinery or Equipment:
(Describe Type & Process)
18. Make:
19. Model:
20. Serial Number / ID Number:
21. Date Placed In Operations:
22. Portion or Control Applicable: (%)
PART 5 – Installed Cost
23. Installed/Acquired Cost:
24. Annual Depreciation: 25. Acc. Depreciation: 26. Net Book Value:
27. Installed Year:
28. Useful Life:
(Yrs.)
29. Remaining Life:
(Yrs.)
Note for Part 5, #23. If Installed/Acquired Cost Differs from Original Reported Cost please
submit explanation below (i.e. expansion, replacement, repair, accounting adjustment ect.)
PART 6 – Construction Work In Process
30. CWIP Supplemental Detail:
PART 7 – Certification
31. The forgoing information is submitted in accordance with the provisions of Section 39-11-105, (a), (x), and
they Wyoming Dept. of Revenue Rules & Regulations, and is true and correct to the best of my knowledge,
information and believed under penalty of perjury.
Signature:
Title:
Date:
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TAX EXEMPTION OF FIRE SUPPRESSION PROPERTY
INSTRUCTIONS FOR SUBMITTING APPLICATION
Excerpt from Wyoming Department of Revenue, Rule & Regulations.
Chapter 14, Section 8, 2014
Property Tax Exemption Standards –
“Fire engines or a station” means dedicated equipment and land and improvements similar to that
owned by governmental entities as fire engines or fire stations used exclusively to support fire
fighting activities. The fundamental basis for the exemption is the benefit conferred upon the
public by privately-owned fire engines and fire stations, and the consequent relief, to some
extent, of the burden upon the state to use its facilities and equipment to support fire fighting
activities.
“Equipment used to extinguish fires” means equipment functionally capable of extinguishing
fires, which is primarily and typically used for fire suppression. The phrase does not include
equipment used to protect the health or safety of employees in fire situations nor
equipment used to detect the presence of fire.
Applicants seeking tax exemption of facilities and/or equipment used for Fire Suppression, as
provided by Section 39-11-105, (a) (x), SHALL:
(A) Complete an application for each item of exemption being sought, and submit by mail.
Application must be submitted, annually on or before February 15
th
(excluding
weekends/holidays). Incomplete applications or those received after the deadline will not
be accepted or considered for exemption.
County Assessed Properties:
(B) Attach additional sheets where necessary, with required information identified by
corresponding item numbers from the application.
County Assessor’s Office
(Where Property/Equipment is Located)
(PART 1 & 2 – Tax Payer & Representative Identification)
Self Explanatory
(PART 3 – Plant & Property Location)
Describe the location and nature of the operating property where the fire suppression equipment is
operated. Include physical address and/or legal description of the property, county, tax district and
date placed into service.
(PART 4 – Exemption Request)
Detailed description of the individual facility, device, equipment, etc. being considered for
exemption (extinguisher, fire engine, sprinkler system, etc.). One item per application, do not
combine multiple pieces of equipment on an application. Include Make, Model, and/or Serial
Number (or any other identifiers) and date placed into operations.
(PART 5 – Installed Cost)
Self Explanatory
(PART 6 – Construction Work In Progress)
Provide any supplemental detail, including cost information for fire suppression equipment included
within Construction Work In Progress accounts.