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        SUPPORTING SCHEDULE FOR DEDUCTION OF                                                                              JANUARY 1, 20 _____
        ASSESSED VALUATIONON A PERSONAL 
        PROPERTY SOLAR POWER DEVICE                                                                                       FORM  103-SPD
        State Form 55063 (R2 / 11-16)                                                                                     PRIVACY NOTICE
        Prescribed by the Department of Local Government Finance                                                   This form contains information 
                                                                                                               confidential pursuant to IC 6-1.1-35-9.
INSTRUCTIONS: 
1.  To claim a deduction on a personal property solar power device, the owner should file the Form SES/WPD with theCounty Auditor of the county in which 
 the property is located.
2.  In order to verify that the solar power device was reported for taxation on the owner’s personal property return, theowner should attach the Form 103-SPD 
 to his original personal property return or his amended personal propertyreturn.
3.  This deduction applies to a solar power device installed after December 31, 2011.
4.  This schedule must be filed for each year the deduction is being claimed.   

NOTE: This deduction is not removed from the assessed value reflected on the personal property return but is determined at a later time by the County Auditor 
and then deducted from the assessed value before tax statements are mailed.  

 SECTION 1                                                          TAXPAYER INFORMATION
 Name of taxpayer                                                               Name of contact person

 Address of taxpayer (number and street, city, state, and ZIP code)                                              Telephone number
                                                                                                                 (              )
 County                                       Township                                                DLGF taxing district number

 SECTION 2                                    INFORMATION ON QUALIFIED PERSONAL PROPERTY
 DATE OF              POOL LINE NUMBER        GENERAL DESCRIPTION OF QUALIFYING                    COST REPORTED TTV% FROM             TRUE TAX VALUE 
 ACQUISITION          FROM 103-LONG                                 EQUIPMENT                      ON 103-LONG            103-LONG 
 (month, day, year) 

                                                                                                                                 %

                                                                                                                                 %

                                                                                                                                 %

                                                                                                                                 %

                                                                                                                                 %

                                                                                                                                 %
                                                                                     TOTALS

 On the Form 103-Long, was Line 53 greater than Line 52 Column D?                Yes             No
 If you answered “No”, round the true tax value above to the nearest $10 and enter that amount to the Form SES/WPD 
 on the line titled “Total deduction claimed”.
                                                                                                                          Enter amount here.
 If you answered “Yes” to the above question, multiply the Total Cost from this form by 30%, round it to the nearest $10, 
 and enter that amount to the Form SES/WPD on the line titled “Total deduction claimed”.                                  $

                                                                    SIGNATURE AND VERIFICATION
 Under the penalties of perjury, I hereby certify that this return to the best of my knowledge and belief, is true, correct and complete, and reports the total 
 cost of all personal property claimed by the taxpayer to qualify for the deduction pursuant to IC 6-1.1-26.1.
 Signature of authorized person                                     Title                                                 Date signed (month, day, year)

 Signature of person preparing return based on all information of which he/she has any knowledge                          Date signed (month, day, year)