Form PVR-4004 "Vermont Tax Inventory to Be Filed With the Listers or Assessors on or Before April 20" - Vermont

What Is Form PVR-4004?

This is a legal form that was released by the Vermont Department of Taxes - a government authority operating within Vermont. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2020;
  • The latest edition provided by the Vermont Department of Taxes;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form PVR-4004 by clicking the link below or browse more documents and templates provided by the Vermont Department of Taxes.

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Download Form PVR-4004 "Vermont Tax Inventory to Be Filed With the Listers or Assessors on or Before April 20" - Vermont

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Form PVR-4004
Vermont Tax Inventory to Be Filed with the Listers or Assessors on or before April 20
Return this inventory to the town where the property is located on or before April 20. When a taxpayer required by law to
make and return an inventory but refuses to sign, swear to, or affirm an inventory, the taxpayer will be fined not more than $100.00.
32 V.S.A. § 4006
Name
Name or address corrections requested
Mailing Address
City
State
ZIP Code
Persons taxable only for real estate shall not be required to file an inventory unless notified to do so by a lister.
Fill in when applicable (see instructions)
Fair Market Value
SCHEDULE A - REAL ESTATE
as of April 1
Year
Depreciated
Acquired
Cost
Book Value
Owners
Listers
1. Land (No. of Acres
or lot size
)
$
$
$
$
2. Buildings (May include mobile homes)
3. Equipment required by Statute to be listed as Real Estate
4. Buildings, including mobile homes on leased land
5. Mining or quarry rights, where land is owned by another
6. Water rights
7.
8.
Total
$
$
$
$
Statutory Ratio
- Listed Value = 100%
$
If you are responsible for property taxes, list all taxable personal property located in town on April 1, which was owned by you or in
your charge. See instructions on other side.
Fill in when applicable (see instructions)
Fair Market Value
SCHEDULE B - TAXABLE PERSONAL PROPERTY
as of April 1
Year
Depreciated
Acquired
Cost
Book Value
Owners
Listers
1. Inventories of:
$
$
$
$
(a) Goods, manufactured products, and merchandise for sale
(b) Raw materials and goods in process of manufacture
(c) Office, shipping, manufacturing, and other supplies
(d) Other
2. Equipment
(a) Manufacturing equipment not, by law, set as real estate
(b) Office, store, shop, or other furniture and equipment
(c) Gasoline pumps with tanks if not listed as real estate. (If by terms
of lease, you do not pay tax, give name & address of owner.)
(d) Other machinery and equipment
3. General
(a) Household furniture and equipment used for income-producing purposes
(b) All taxable personal property, owned by persons or corporations
without this state, which were in charge of the maker hereof
(c) Standing timber owned without the land
(d) Mobile homes or trailer coach not affixed to land
Total
$
$
$
$
Statutory Ratio
- Listed Value = 100%
$
Form PVR-4004
Page 1 of 2
Rev. 03/20
Form PVR-4004
Vermont Tax Inventory to Be Filed with the Listers or Assessors on or before April 20
Return this inventory to the town where the property is located on or before April 20. When a taxpayer required by law to
make and return an inventory but refuses to sign, swear to, or affirm an inventory, the taxpayer will be fined not more than $100.00.
32 V.S.A. § 4006
Name
Name or address corrections requested
Mailing Address
City
State
ZIP Code
Persons taxable only for real estate shall not be required to file an inventory unless notified to do so by a lister.
Fill in when applicable (see instructions)
Fair Market Value
SCHEDULE A - REAL ESTATE
as of April 1
Year
Depreciated
Acquired
Cost
Book Value
Owners
Listers
1. Land (No. of Acres
or lot size
)
$
$
$
$
2. Buildings (May include mobile homes)
3. Equipment required by Statute to be listed as Real Estate
4. Buildings, including mobile homes on leased land
5. Mining or quarry rights, where land is owned by another
6. Water rights
7.
8.
Total
$
$
$
$
Statutory Ratio
- Listed Value = 100%
$
If you are responsible for property taxes, list all taxable personal property located in town on April 1, which was owned by you or in
your charge. See instructions on other side.
Fill in when applicable (see instructions)
Fair Market Value
SCHEDULE B - TAXABLE PERSONAL PROPERTY
as of April 1
Year
Depreciated
Acquired
Cost
Book Value
Owners
Listers
1. Inventories of:
$
$
$
$
(a) Goods, manufactured products, and merchandise for sale
(b) Raw materials and goods in process of manufacture
(c) Office, shipping, manufacturing, and other supplies
(d) Other
2. Equipment
(a) Manufacturing equipment not, by law, set as real estate
(b) Office, store, shop, or other furniture and equipment
(c) Gasoline pumps with tanks if not listed as real estate. (If by terms
of lease, you do not pay tax, give name & address of owner.)
(d) Other machinery and equipment
3. General
(a) Household furniture and equipment used for income-producing purposes
(b) All taxable personal property, owned by persons or corporations
without this state, which were in charge of the maker hereof
(c) Standing timber owned without the land
(d) Mobile homes or trailer coach not affixed to land
Total
$
$
$
$
Statutory Ratio
- Listed Value = 100%
$
Form PVR-4004
Page 1 of 2
Rev. 03/20
FIRE INSURANCE
(a) Buildings
$
State amount of fire
(b) Machinery and equipment
$
insurance carried on
(c) Inventories of goods and supplies
$
LISTERS’ MEMORANDUM
INSTRUCTIONS
Similar items may be grouped by year of purchase. A separate line should be used for items fully depreciated for IRS purposes. Cost
includes all costs accrued to all taxable items. When purchased “used,” indicate by “u” after cost. If owner’s value differs substantially
from depreciated cost, please explain. Mobile homes in inventory on a sales lot and not affixed to land would be classified as personal
property in Section B on Line 3(d), when set up on land they would be included as real estate in Schedule A on Line 2 if owner of mobile
home owns the land, or on Line 4 if on leased land.
SIGNATURE
I do solemnly swear (or affirm), under the pains and penalties of perjury, that, to the best knowledge and belief, the foregoing inventory
by me subscribed is a full, true, and correct list and description of all taxable property, both real and personal, which should be set in the
list to me. (32 V.S.A. §§ 4002 and 4006)
_____________________________________
____________________
Signature
Date
Form PVR-4004
Page 2 of 2
Rev. 03/20
Page of 2