State Form 11405 Form 103 - Long - Business Tangible Personal Property Assessment Return - Indiana

Form State11405 or the "Form 103 - Long - Business Tangible Personal Property Assessment Return" is a form issued by the Indiana Department of Local Government Finance.

The form was last revised in October 1, 2018 and is available for digital filing. Download an up-to-date Form State11405 in PDF-format down below or look it up on the Indiana Department of Local Government Finance Forms website.

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BUSINESS TANGIBLE PERSONAL
FORM 103 - LONG
JANUARY 1, 2019
PROPERTY ASSESSMENT RETURN
For Assessor's Use Only
PRIVACY NOTICE
State Form 11405 (R41 / 10-18)
This form contains information
confidential pursuant to IC 6-1.1-35-9.
Prescribed by the Department of Local Government Finance
NOTE: For taxpayers with less than $20,000 in acquisition costs to report within the county, legislation was passed in 2015 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 and IV
of this form. If you are declaring this exemption through this form, you do not need to file a Form 104.
$ ________________________
RETURN THIS FORM TO THE APPLICABLE ASSESSOR BY MAY 15, 2019.
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.
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, 2019,
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 unless the exemption above is claimed.
SECTION I
Name of taxpayer
Federal identification number **
Name under which business is conducted
DLGF taxing district number
Address where property is located (number and street, city, state, and ZIP code)
DLGF taxing district name
Nature of business
Township
NAICS Code number *
Name and address to which Assessment and Tax Notice are to be mailed (If different than above)
County
Retail merchant’s certification number
SECTION II
1. Federal income tax year ends __________________________
Name filed under _________________________________________________
2. Location of accounting records ____________________________________________________________________________________________
3. Form of business
Partnership or Joint Venture
Sole Proprietorship
Corporation
Estate or Trust
Other, describe: ___________________________________________________________________________
4. Do you have other locations in Indiana?
Yes
No
5. Did you own, hold, possess or control any leased, rented or other depreciable personal property on January 1?
Yes
No (See 50 IAC 4.2-8)
6. Did you own, hold, possess or control any Special Tools on January 1?
Yes
No
(See 50 IAC 4.2-6-2)
7. Did you own, hold, possess or control any returnable containers on January 1?
Yes
No
(See 50 IAC 4.2-6-4)
If taxpayer answers "yes" to question 5, the owner must file Form 103-O and the possessor must file Form 103-N. Failure to properly disclose lease information may result in a
double assessment. (See 50 IAC 4.2-2 and 50 IAC 4.2-8).
Failure to file a return on or before the due date as required by law will result in the imposition of a twenty-five dollar ($25) penalty. In addition, if the return is not filed within
thirty (30) days after such return is due, a penalty equal to twenty percent (20%) of the taxes finally determined to be due with respect to the property which should have been
reported will be imposed. A personal property return is not due until the expiration of any extension period granted by the Township Assessor or County Assessor under IC
6-1.1-3-7(b). If the total assessed value that a person reports on a personal property return is less than the total assessed value that the person is required by law to report
and if the amount of the undervaluation exceeds five percent (5%) of the value that should have been reported on the return, then the County Auditor shall add a penalty of
twenty percent (20%) of the additional taxes finally determined to be due as a result of the undervaluation.
In completing a personal property return for a year, a taxpayer must make a complete disclosure of all information relating to the value, nature, or location of personal property
owned, held, possessed or controlled on the assessment date. (IC 6-1.1-3-9(a)). This information would include, but not be limited to, completion of the heading and related
information, answers to all questions on the face of the return, and entries on all of the appropriate lines of Schedule A. If such information is not provided, the taxpayer will be
contacted and directed to provide that information. In addition, a penalty of $25 shall be imposed. (IC 6-1.1-37-7(d))
* NAICS - North American Industry Classification System - A complete list of codes may be found at www.census.gov. The Indiana Code (IC) and Indiana Administrative Code
(IAC) may be found on-line at the DLGF website - www.in.gov/dlgf. For further questions, contact the County Assessor (available on the DLGF website).
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 digits of that number. IC 4-1-10-3.
SECTION III
SUMMARY (Round all numbers to nearest ten dollars)
REPORTED BY TAXPAYER
CHANGE BY ASSESSOR
CHANGE BY THE COUNTY BOARD
$
$
$
Schedule A - Personal Property
+
$
$
$
Deduction per Form 103 ERA or Form 103-CTP
-
$
$
$
Final Assessed Valuation
=
SECTION IV
SIGNATURE AND VERIFICATION
Under penalties of perjury, I hereby certify that this return (including any accompanying schedules, deduction claims, or 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 of authorized person
Telephone number
Date (month, day, year)
(
)
Name and title of authorized person (please type or print)
E-mail contact
Signature of person preparing return, if different than authorized person
Name and contact information of preparer (please type or print)
Page 1 of 4
Reset Form
BUSINESS TANGIBLE PERSONAL
FORM 103 - LONG
JANUARY 1, 2019
PROPERTY ASSESSMENT RETURN
For Assessor's Use Only
PRIVACY NOTICE
State Form 11405 (R41 / 10-18)
This form contains information
confidential pursuant to IC 6-1.1-35-9.
Prescribed by the Department of Local Government Finance
NOTE: For taxpayers with less than $20,000 in acquisition costs to report within the county, legislation was passed in 2015 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 and IV
of this form. If you are declaring this exemption through this form, you do not need to file a Form 104.
$ ________________________
RETURN THIS FORM TO THE APPLICABLE ASSESSOR BY MAY 15, 2019.
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.
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, 2019,
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 unless the exemption above is claimed.
SECTION I
Name of taxpayer
Federal identification number **
Name under which business is conducted
DLGF taxing district number
Address where property is located (number and street, city, state, and ZIP code)
DLGF taxing district name
Nature of business
Township
NAICS Code number *
Name and address to which Assessment and Tax Notice are to be mailed (If different than above)
County
Retail merchant’s certification number
SECTION II
1. Federal income tax year ends __________________________
Name filed under _________________________________________________
2. Location of accounting records ____________________________________________________________________________________________
3. Form of business
Partnership or Joint Venture
Sole Proprietorship
Corporation
Estate or Trust
Other, describe: ___________________________________________________________________________
4. Do you have other locations in Indiana?
Yes
No
5. Did you own, hold, possess or control any leased, rented or other depreciable personal property on January 1?
Yes
No (See 50 IAC 4.2-8)
6. Did you own, hold, possess or control any Special Tools on January 1?
Yes
No
(See 50 IAC 4.2-6-2)
7. Did you own, hold, possess or control any returnable containers on January 1?
Yes
No
(See 50 IAC 4.2-6-4)
If taxpayer answers "yes" to question 5, the owner must file Form 103-O and the possessor must file Form 103-N. Failure to properly disclose lease information may result in a
double assessment. (See 50 IAC 4.2-2 and 50 IAC 4.2-8).
Failure to file a return on or before the due date as required by law will result in the imposition of a twenty-five dollar ($25) penalty. In addition, if the return is not filed within
thirty (30) days after such return is due, a penalty equal to twenty percent (20%) of the taxes finally determined to be due with respect to the property which should have been
reported will be imposed. A personal property return is not due until the expiration of any extension period granted by the Township Assessor or County Assessor under IC
6-1.1-3-7(b). If the total assessed value that a person reports on a personal property return is less than the total assessed value that the person is required by law to report
and if the amount of the undervaluation exceeds five percent (5%) of the value that should have been reported on the return, then the County Auditor shall add a penalty of
twenty percent (20%) of the additional taxes finally determined to be due as a result of the undervaluation.
In completing a personal property return for a year, a taxpayer must make a complete disclosure of all information relating to the value, nature, or location of personal property
owned, held, possessed or controlled on the assessment date. (IC 6-1.1-3-9(a)). This information would include, but not be limited to, completion of the heading and related
information, answers to all questions on the face of the return, and entries on all of the appropriate lines of Schedule A. If such information is not provided, the taxpayer will be
contacted and directed to provide that information. In addition, a penalty of $25 shall be imposed. (IC 6-1.1-37-7(d))
* NAICS - North American Industry Classification System - A complete list of codes may be found at www.census.gov. The Indiana Code (IC) and Indiana Administrative Code
(IAC) may be found on-line at the DLGF website - www.in.gov/dlgf. For further questions, contact the County Assessor (available on the DLGF website).
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 digits of that number. IC 4-1-10-3.
SECTION III
SUMMARY (Round all numbers to nearest ten dollars)
REPORTED BY TAXPAYER
CHANGE BY ASSESSOR
CHANGE BY THE COUNTY BOARD
$
$
$
Schedule A - Personal Property
+
$
$
$
Deduction per Form 103 ERA or Form 103-CTP
-
$
$
$
Final Assessed Valuation
=
SECTION IV
SIGNATURE AND VERIFICATION
Under penalties of perjury, I hereby certify that this return (including any accompanying schedules, deduction claims, or 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 of authorized person
Telephone number
Date (month, day, year)
(
)
Name and title of authorized person (please type or print)
E-mail contact
Signature of person preparing return, if different than authorized person
Name and contact information of preparer (please type or print)
Page 1 of 4
SECTION V
FORM 103 - LONG
TANGIBLE PERSONAL PROPERTY
SCHEDULE A
See 50 IAC 4.2-4
CONFIDENTIAL
JANUARY 1, 2019
Federal Identification Number
Line
Report all personal property assessable to this taxpayer below. (Round all figures below to nearest dollar)
1
Total cost of tangible depreciable personal property. (50 IAC 4.2-4-2)
$
2
Adjustment to federal tax basis per Form 106. (50 IAC 4.2-4-4)
3
Total cost and base year value of tangible depreciable personal property. (Line 1 plus 2)
$
Deduct Exempt Property (See 50 IAC 4.2-11.1)
COST
4
Stationary industrial air purification systems. (Attach Form 103-P)
$
5
Industrial waste control facilities. (Attach Form 103-P)
6
Enterprise information technology equipment. (Attach Form 103-IT)
Number of Units
7
Vehicles / airplanes subject to excise tax.
$
Total cost of exempt property (Deduct from Line 3 and enter on Line 8)
Subtotal
8
$
Additions: See 50 IAC 4.2-1-1.1 and 50 IAC 4.2-4-3(b) and 4
9
Cost of all depreciable personal property still in use but written off. (50 IAC 4.2-4-3(b))
$
10
Cost of installation and foundations applicable to depreciable personal property. (50 IAC 4.2-4-2(d))
Cost of interest incurred during construction and installation applicable to depreciable personal property.
11
(50 IAC 4.2-4-3(j))
Total cost and base year value of assessable depreciable personal property.
12
(add Lines 8, 9, 10 and 11. Line 12 must agree with Line 52 Column A)
$
TOTAL COST
ADJUSTMENTS
ADJUSTED COST
POOLING SUMMARY
TRUE TAX VALUE
COLUMN A
COLUMN B
COLUMN C
(From Schedule A-1 or Form 103-P5)
COLUMN D
52
Total All Pools
$
$
$
$
30% of Adjusted Cost (Line 52, Column C) (enter zero (0) if filing 103-P5
53
and entity is a qualified steel mill or oil refinery per IC 6-1.1-3-23).
$
54
Greater of Lines 52D or 53.
$
Adjustments to True Tax Value
Cost
Equipment not placed in service and/or critical
55
X 10%
$
spare parts (50 IAC 4.2-6-1 & 6) per Form 106.
Cost
56
Tools, dies, jigs, fixtures, etc., per Form 103-T. (50 IAC 4.2-6-2)
$
$
Cost
Permanently retired equipment (50 IAC 4.2-4-3) and/or returnable
57
$
containers (50 IAC 4.2-6-4) per Form 106.
$
Cost
Commercial aircraft and commercial bus line fleet, not subject to excise tax per
58
$
Form 103-I. (50 IAC 4.2-10)
$
59
Total additions to True Tax Value. (Lines 55, 56, 57 and 58)
$
60
Total True Tax Value before adjustments for "Abnormal Obsolescence." (Line 54 plus Line 59)
$
61
Abnormal Obsolescence Adjustment per Form 106. (50 IAC 4.2-4-8)
$
62
Total True Tax Value of personal property. (To page 1, Form 103 Summary)
$
Page 2 of 4
FORM 103 - LONG
SCHEDULE A-1
TANGIBLE PERSONAL PROPERTY
JANUARY 1, 2019
See 50 IAC 4.2-4
CONFIDENTIAL
* * The total cost of special tools, dies, jigs, fixtures, etc., permanently retired equipment; commercial aircraft, and commercial bus line fleet, not subject
to excise tax is to be deducted in full in Column B below. The true tax value of such property is to be computed on the proper Form(s) (103-T, 106
AND 103-I, respectively) and recorded on Line(s) 56, 57 and 58.
ROUND ALL FIGURES BELOW TO THE NEAREST DOLLAR.
YEAR OF ACQUISITION
COLUMN A
COLUMN B
COLUMN C
COLUMN D
POOL NUMBER 1:
TOTAL COST OR
ADJUSTMENTS
ADJUSTED COST
T.T.V.%
TRUE TAX VALUE
(1 TO 4 YEAR LIFE)
BASE YEAR VALUE
** (See Note Above)
13
65
1-2-18 To 1-1-19
14
50
1-2-17 To 1-1-18
15
35
1-2-16 To 1-1-17
16
20
Prior To 1-2-16
$
$
$
$
17
TOTAL POOL NUMBER 1
POOL NUMBER 2: (5 TO 8 YEAR LIFE)
18
40
1-2-18 To 1-1-19
19
56
1-2-17 To 1-1-18
20
42
1-2-16 To 1-1-17
21
32
3-2-15 To 1-1-16
22
24
3-2-14 To 3-1-15
23
18
3-2-13 To 3-1-14
24
15
Prior To 3-2-13
$
$
$
$
25
TOTAL POOL NUMBER 2
POOL NUMBER 3: (9 TO 12 YEAR LIFE)
26
40
1-2-18 To 1-1-19
27
60
1-2-17 To 1-1-18
28
55
1-2-16 To 1-1-17
29
3-2-15 To 1-1-16
45
30
37
3-2-14 To 3-1-15
31
30
3-2-13 To 3-1-14
32
25
3-2-12 To 3-1-13
33
20
3-2-11 To 3-1-12
34
3-2-10 To 3-1-11
16
35
12
3-2-09 To 3-1-10
36
10
Prior To 3-2-09
$
$
$
$
37
TOTAL POOL NUMBER 3
POOL NUMBER 4: (13 YEAR AND LONGER LIFE)
38
40
1-2-18 To 1-1-19
39
1-2-17 To 1-1-18
60
40
63
1-2-16 To 1-1-17
41
54
3-2-15 To 1-1-16
42
46
3-2-14 To 3-1-15
43
40
3-2-13 To 3-1-14
44
3-2-12 To 3-1-13
34
45
29
3-2-11 To 3-1-12
46
25
3-2-10 To 3-1-11
47
21
3-2-09 To 3-1-10
48
15
3-2-08 To 3-1-09
49
10
3-2-07 To 3-1-08
50
Prior To 3-2-07
5
$
$
$
$
51
TOTAL POOL NUMBER 4
52
TOTAL ALL POOLS
NOTE: All Column B adjustments above must be supported on Form 106, Form 103-T, or Form 103-I.
Page 3 of 4
Filing Basics:
Effective July 1, 2015, IC 6-1.1-3-7.2 was amended to allow an exemption for taxpayers with less than $20,000
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.
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, 2019, and should include a reason for the request.
The Assessor may, at their discretion, approve or deny 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 Indiana Department of Local Government Finance’s website at www.in.gov/dlgf.
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-Long, 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.
Frequently Asked Questions:
A.
How do I find out my Taxing District Name and Number?
You will need to contact your County Assessor for assistance since heavily populated areas can have several
taxing districts within a single township.
B.
How do I find out my NAICS number?
This six-digit code number appears on the federal returns filed for businesses. For a complete list of the codes,
go to
www.census.gov.
C.
Will my local Assessor fill this form out for me?
Indiana’s personal property tax system is a self-assessment system. An Assessor can offer assistance with the
filing; however, an authorized person representing the business must sign the form under penalties of perjury
that it is true and correct so the responsibility of filing an accurate return remains with the taxpayer.
D.
How can I find contact information for the various county offices (Assessor, Auditor, or Treasurer)
throughout the State of Indiana, locate forms or learn more about Indiana’s personal property tax system?
Go to the Indiana Department of Local Government Finance’s website at
www.in.gov/dlgf.
Contact information for the Assessor is available at http://www.in.gov/dlgf/2440.htm.
SECTION VI
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
Location of
Date of Lease
Model Number
Cost,
Quantity
Address of the Owner
Property
(month, day, year)
and Description
if Known
Page 4 of 4

Download State Form 11405 Form 103 - Long - Business Tangible Personal Property Assessment Return - Indiana

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