Reset Form
           INFORMATION RETURN OF                                                     FORM  103-N                                 JANUARY 1, 20 ____
           NOT OWNED PERSONAL PROPERTY                                               SCHEDULE 1                     For Assessor's use only
           State Form 23000 (R9 / 11-16)
           Prescribed by Department of Local Government Finance                      PRIVACY NOTICE
                                                                                This form contains information 
                                                                             confidential pursuant to IC 6-1.1-35-9.
INSTRUCTIONS:   The form may be used in order to comply with 
           IC 6-1.1-2-4(a) and 50 IAC 4.2-2-4.
 Name of person in possession of property (please type or print)                                                    County

 Address (number and street, city, state, and  ZIP code)                                                            DLGF taxing district number

           Report all personal property held, possessed or controlled on January 1 of the current assessment year, in Schedule I or Schedule II.
                                                       SCHEDULE I - ASSESSED TO OWNER ON FORM 102 OR 103
 Information return of all personal property which was held, possessed or controlled by this taxpayer but owned as of January 1 of the current 
 assessment year by the OWNER. (If Special Tools, report on Form 103-T.) (See 50 IAC 4.2-2-4 and 5; and 50 IAC 4.2-8-3 and 4.)
                                                                                                                                               COST
           NAME AND ADDRESS                                      LOCATION OF    DATE OF    MODEL NUMBER             QUANTITY                  (If Known)
           OF OWNER                                              PROPERTY            LEASE AND DESCRIPTION

                                                                                                                    TOTAL

IC 6-1.1-2-4 Liability for tax
Sec. 4.(a) A person holding, possessing, controlling, or occupying any personal property on the assessment date of a year is liable for the taxes imposed for 
that year on the property unless: (1) the person establishes that the property is being assessed and taxed in the name of the owner; or (2) the owner is liable 
for the taxes under a contract with that person.
50 IAC 4.2-2-4 Liability
Sec. 4.(a) The owner of any personal property on the assessment date of a year is liable for the taxes imposed for that year on the property. 
(b) Possessory interests. A person holding, possessing, or controlling any personal property on the assessment date of a year is liable for the taxes imposed for 
that year on the property unless they establish that the property is being assessed and taxed in the name of the owner, or the owner is liable for the taxes under 
a contract with that person and that person files a correct Form 103-N supplemental information return on or before the due date.
Schedule I includes, but is not limited to, the reporting of:
          Returnable Containers; Operating Leases; and all other property held, 
          possessed or controlled by this taxpayer but owned by another person.
Excluded from Schedule I is:
          Personal property subject to Capital Lease - See Schedule II.
          Special Tools - See Form 103-T

                                                                          Page 1 of 2

         FORM 103-N                                                      SCHEDULE II                                     JANUARY 1, 20 ____
Name of person in possession of property (please type or print)                                      County

Address (number and street, city, state, and ZIP code)                                               DLGF taxing district number

         Report all personal property held, possessed or controlled on January 1 of the current assessment year, in Schedule I or Schedule II.
                    TO BE ASSESSED AS A CAPITAL LEASE to person holding, possessing or controlling property.
Information return of all personal property which was held, possessed or controlled as of January 1 of the current assessment year by this taxpayer but 
owned by another person. (If Special Tools, report on Form 103-T.) (See 50  IAC 4.2-2-4 and 5; and 50 IAC 4.2-8-3 and 4.)

                    TO BE ASSESSED AS A CAPITAL LEASE TO PERSON IN POSSESSION OF PROPERTY
         NAME AND ADDRESS                                       LOCATION OF DATE OF  MODEL NUMBER    LINE NO. REPORTED                        COST 
                                                                                                     ON FORM 102 / 103
         OF OWNER                                               PROPERTY    LEASE    AND DESCRIPTION IF APPLICABLE            PER 50 IAC 4.2

Schedule II includes personal property subject to Capital Lease only.                                                    TOTAL

                                                                         Page 2 of 2