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               BUSINESS TANGIBLE PERSONAL PROPERTY                                                   FORM  103 – P5 / ERA                         JANUARY 1, 2024 
                                                                                                                                                For Assessor's Use Only 
               DEPRECIABLE ASSETS IN POOL 5                                                               PRIVACY NOTICE 
               State Form 52498 (R19 / 1-24)                                                         This form contains confidential 
                                                                                                     information pursuant to IC 6-1.1-35-9. 
               Prescribed by the Department of Local Government Finance 
INSTRUCTIONS:  
1. In order to receive a deduction, this schedule must be submitted with Form 103  Long.2. A separate schedule must be completed for each approved Form SB-1/PP for that abatement.
3. Attach a copy of the applicable Form CF-1 to this schedule.
4. For any acquisitions since the last assessment date, attach a list of the new equipment that is included on Form 103  EL.SECTION 1                                                               TAXPAYER INFORMATION 
Name of Taxpayer                                                                                                                Federal Identification Number 

Full Address (number and street, city, state, and ZIP code)                                                                     Email Address 

County                                                        Township                                              DLGF Taxing District Number 

Contact Person                                                Title                                                 Telephone Number 
                                                                                                                    (         ) 

   SECTION 2                                                ECONOMIC REVITALIZATION AREA INFORMATION 
Name of Body Designating the Economic Revitalization Area                                     Resolution Number                 Length of Abatement (Years) 

Date Designation Approved (month, day, year)   Date Designation Terminates (month, day, year) Does Resolution Limit Dollar Amount of Deduction? ☐ Yes – Assessed Value
                                                                                              ☐  Yes – and limit is based on equipment☐     Yes – Cost☐ No
   SECTION 3                                          SCHEDULE OF POOLED EQUIPMENT UNDER ABATEMENT 
The total cost of depreciable assets is to be reported on Form 103 – Long. This schedule includes only the new manufacturing, research and development, 
logistical distribution, and/or information technology equipment that is deductible per the resolution and IC 6-1.1-12.1. 
                                                                                                Abatement 
       POOL NUMBER 5                        TTV %             True Tax Value                                      Deduction Claimed               Deduction Approved 
(Pursuant to IC 6-1.1-3-23 or 23.5)                           [per Form 103 – P5]             Year   Percent 
01           1-2-23 to 1-1-24               40%             $                                 1                 $                               $ 
02           1-2-22 to 1-1-23               56%             $                                 2                 $                               $ 
03           1-2-21 to 1-1-22               42%             $                                 3                 $                               $ 
04           1-2-20 to 1-1-21               32%             $                                 4                 $                               $ 
05           1-2-19 to 1-1-20               24%             $                                 5                 $                               $ 
06           1-2-18 to 1-1-19               18%             $                                 6                 $                               $ 
07           1-2-17 to 1-1-18               15%             $                                 7                 $                               $ 
08           1-2-16 to 1-1-17               10%             $                                 8                 $                               $ 
09           3-2-15 to 1-1-16               10%             $                                 9                 $                               $ 
10           3-2-14 to 3-1-15               10%             $                                 10                $                               $ 
       TOTAL POOL NUMBER 5                                  $                                 --       --       $                               $ 
   SECTION 4                                                        SPECIAL TOOLING UNDER ABATEMENT 
Round all figures to the nearest $1. Report only cost         True Tax Value                    Abatement 
of abated special tools, dies, jigs, etc.  (50 IAC 4.2-6-2)   [per Form 103 – P5]                                 Deduction Claimed               Deduction Approved 
                                                                                              Year   Percent 
                 1-2-23 to 1-1-24           30%             $                                 1                 $                               $ 
                 1-2-22 to 1-1-23           3%              $                                 2                 $                               $ 
                 1-2-21 to 1-1-22           3%              $                                 3                 $                               $ 
                 1-2-20 to 1-1-21           3%              $                                 4                 $                               $ 
  True Tax       1-2-19 to 1-1-20           3%              $                                 5                 $                               $ 
  Value of 
Acquisitions     1-2-18 to 1-1-19           3%              $                                 6                 $                               $ 
                 1-2-17 to 1-1-18           3%              $                                 7                 $                               $ 
                 1-2-16 to 1-1-17           3%              $                                 8                 $                               $ 
                 3-2-15 to 1-2-16           3%              $                                 9                 $                               $ 
                 3-2-14 to 3-1-15           3%              $                                 10                $                               $ 
TOTAL SPECIAL TOOLS                                         $                                 --       --       $                               $ 
TOTAL POOL 5 AND SPECIAL TOOLING                                                                                $                               $ 
LIMIT ON AMOUNT OF ABATEMENT STATED IN RESOLUTION                                             Cost $                         OR             AV  $ 
AMOUNT OF DEDUCTION CLAIMED (Lesser of Limit on Abatement and Total of Pools)                                   $                               $ 
☐ Check if taxpayer has also filed Form 103 – Long and Form 103 – ERA with personal property in Pools 1, 2, 3, or 4.






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