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BRENT JOHNSON                                                                             GREENE COUNTY ASSESSOR          ASSESSMENT LIST
Assessor, Greene County, MO                                                               940 N Boonville Ave Rm 37 Dear Greene County Resident: This form is used by the county assessor 
940 North Boonville Ave., Rm. 37                                                                                                                                  to determine the taxable value of your personal property, e.g. vehicles, 
Springfield, MO 65802-3802                                                                Springfield, MO 65802-3802recreational equipment, livestock, farm machinery, etc. You are required 
                                                                                                                                                                  by law to list all personal property belonging to you or under your control 
Phone: 417-868-4191Fax: 417-829-6193                                                                                                                           in Greene County, Missouri, on Jan. 1st. Complete form, sign and return by 
PersonalProperty@greenecountymo.gov                                                                                                                               March 1st to avoid penalty. 
          AVOID PENALTY Return by March 1st

                                                                                                                                                                  BRENT JOHNSON
                                                                                                                                                                  GREENE COUNTY ASSESSOR
                                                                                                                                                                  940 NORTH  BOONVILLE AVE  RM 37
                                                                                                                                                                  SPRINGFIELD MO  65802-3802

Primary Phone: _____________________  Secondary Phone: _____________________                                                                                      File     Online:  
Email: ____________________________________________________________________
Military personnel: Fill out this form only if your home of record is Greene County, MO.
HAVE YOU MOVED WITHIN THE LAST YEAR?   NO    YES  (If Yes, indicate below)                  
Date Moved __________________                 New Address _______________________________________________________________________________________________________________________________ 
                                                                                                    Street                                                                 City                                    State                      Zip

NOTE:List physical   *The Assessor’saddress ifOfficeDIFFERENTwill notfromacceptmailingany assessmentsaddress  *_______________________________________________________________________________________that have a P.O. box without a physical address also listed on the form.
IMPORTANT:                                           Last year you reported the property shown below.                                                                                         HOW TO REMOVE AN ITEM:
                                                                                                                                                                  st
1. Please draw a line through any items you did NOT own on Jan. 1                                                                                                                                       EXAMPLE                      
2. List ANY items NOT SHOWN in this box in the areas below or on back.

                                                                                                                                    Please add the VIN for any items in this box that do not 
                                                                                                                                    list one. Please also add the VIN to any newly purchased 
                                                                                                                                    items that you list below. This 17 digit number can be 
                                                                                                                                    found on your insurance card.

              Please place an      in one of these boxes after completing front and back of form.  Sign before returning.
                                  CHANGES                                                                           NO CHANGES                                                                NO PROPERTY
                                  MADE                                                                              MADE                                                                      OWNED
I have read and understand the instructions above and on back.  I do hereby certify that the foregoing list contains a true and correct statement of all the tangible personal property, made  
taxable by the laws of the State of Missouri, which I owned or which I had under my charge or management on the first day of January. I further certify that I have not sent or taken, or caused 
to be sent or taken, any property out of this state to avoid taxation. Any person who refuses to make the certification to the list, when required so to do by the assessor or the assessor’s 
deputy, shall upon conviction be deemed guilty of a misdemeanor and no property shall be exempt from executions issued on judgments in prosecutions pursuant  to this section.   

SIGN           HERE +                                                                     SIGNATURE                                                               DATE                        AREA CODE      DAYTIME PHONE NO.

             Do not re-list any items that appear correctly in yellow box above.
ASSESSMENT LIST MUST BE COMPLETED AND SIGNED OR IT WILL BE RETURNED TO TAXPAYER
                          If your vehicle has a salvage title, please indicate below and attach a copy of the title.
                            VIN (Vehicle ID Number - Required)    **** Please Print Carefully ****                                                                YEAR     MAKE               MODEL          SERIES DRIVE             SALVAGE CAB  DIESEL
                                                                                                                                                                           (Chevy, Ford)      (Impala, F150) (SE, LE) Wheels                  TYPE
AUTOS                                                                                                                                                                                                                 2WD                     REG    
VANS                                                                                                                                                                                                                  4WD              Y   N  EXT    Y   N
                                                                                                                                                                                                                      AWD                     CREW
MINIVANS
                                                                                                                                                                                                                      2WD                     REG    
SUVS                                                                                                                                                                                                                  4WD              Y   N  EXT    Y   N
JEEPS                                                                                                                                                                                                                 AWD                     CREW
                                                                                                                                                                                                                      2WD                     REG    
PICKUP                                                                                                                                                                                                                4WD              Y   N  EXT    Y   N
TRUCKS                                                                                                                                                                                                                AWD                     CREW
Do Not                                                                                                                                                                                                                2WD                     REG    Y   N
List Leased                                                                                                                                                                                                           4WD              Y   N  EXT
Vehicles                                                                                                                                                                                                              AWD                     CREW
                            VIN (Vehicle ID Number - Required)    **** Please Print Carefully ****                                                                YEAR     MAKE               MODEL/ APPORTIONED PLATE?                BED   AXLES GVW
                                                                                                                                                                           (Peterbilt, White) TYPE   Yes   No    AUTHORITY:            TYPE
HEAVY
TRUCKS
SEMIS
CAB &
CHASSIS
(wBODY)

          Vehicles involved in interstate trucking:  Attach Missouri Highway Reciprocity mileage; 
                                                                     otherwise, vehicle will be assessed at 1/3 of trade-in value.
                                                                                                               CONTINUED ON BACK                                                                             GREE2 - 114 (Rev 10/21)
                                                                                                                                                                                                                                                 039



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                                                                                           YEAR       MAKE                 MODEL                                  LENGTH
  RVs         VIN (Vehicle ID Number - Required)   **** Please Print Carefully ****               (Allegro, Dutchman)                                  SERIES
 (MOTOR-
 HOMES)
              VIN (Vehicle ID Number - Required)   **** Please Print Carefully ****        YEAR       MAKE                 MODEL                       SERIES     CC/HP
                                                                                                    (Harley, Polaris) (Fatboy, Sportsman, etc.)
MOTORCYCLES
 BIKES
 ATVs &
 UTVs

              VIN (Vehicle ID Number - Required)   **** Please Print Carefully ****        YEAR       MAKE                 MODEL                SERIES  LENGTH        No. of  
                                                                                                    (Amtm, Bluebird)                                              Passengers
COMMERCIAL
 BUSES

              VIN (Vehicle ID Number - Required)   **** Please Print Carefully ****        YEAR       MAKE            MODEL/TYPE                SERIES AXLES LENGTH     CONST
                                                                                                                                                                        (Circle)
TRAILERS                                                                                                                                                                Steel
 Utility                                                                                                                                                                Alum.
  Boat
  Semi                                                                                                                                                                  Steel
                                                                                                                                                                        Alum.
              VIN (Vehicle ID Number - Required)   **** Please Print Carefully ****        YEAR       MAKE            MODEL/TYPE                       SERIES    LENGTH CONST
                                                                                                                      (Jon, Bass, Ski, Pontoon)                         (Circle)
                                                                                                                                                                        Wood
 BOATS                                                                                                                                                                  Fiber
JETSKIS                                                                                                                                                                 Alum.
                                                                                                                                                                        Wood
                                                                                                                                                                        Fiber
                                                                                                                                                                        Alum.
CAMPERS       VIN (Vehicle ID Number - Required)   **** Please Print Carefully ****        YEAR       MAKE            MODEL/                   HITCH   LENGTH     # SLIDES
                                                                                                                      SERIES                   (Circle)
5th WHEELS
 TRAVEL                                                                                                                             5th Wheel
TRAILERS                                                                                                                                       Bumper
              VIN (Vehicle ID Number - Required)   **** Please Print Carefully ****        YEAR       MAKE            MODEL/        DESCRIPTION                  Purchase Price
                                                                                                                      SERIES        (Backhoe, Dozer, Forklift)
 HEAVY                                                                                                                                                           $
EQUIPMENT
                                                                                                                                                                 $

                                                               MAX. CERTIFIED GROSS HOURS FLOWN       PURCHASE PRICE                                   CIRCLE ONE
AIRCRAFT    YEAR             MAKE         MODEL & SERIES       TAKEOFF WEIGHT                         ESTIMATED VALUE

 (Including                                                                                         $                               HISTORIC            KIT           NA
 Historic                                                                                           $
 and Kit)                                                                                           $                               HISTORIC            KIT           NA
                                                                                                    $
                                  DESCRIPTION               YEAR               MAKE                         MODEL                 YEAR PURCHASED       PURCHASE PRICE
            BRUSH HOG                                                                                                                                  $
            COMBINE                                                                                                                                    $
 FARM       BALER                                                                                                                                      $
 MACH.
            TRACTOR                                                                                                                                    $
            RAKE                                                                                                                                       $
            OTHER                                                                                                                                      $
HISTORIC    YEAR             MAKE                       MODEL            SERIES        HISTORIC PLATES YEAR PURCHASED         PURCHASE PRICE            ESTIMATED VALUE
 AUTO                                                                                      Yes    No
 OTHER      VIN / SERIAL NO.                            YEAR             MAKE          MODEL          SERIES                  YEAR PURCHASED           PURCHASE PRICE
 MOTOR
VEHICLES
            COWS/BULLS            BARROWS/GILTS         EWES                        HORSES                            POULTRY                          OTHER LIVESTOCK
LIVESTOCK   CALVES                SOWS                  FEEDER LAMBS                MULES                             BEE COLONIES
            YEARLINGS             PIGS                  SLAUGHTER LAMBS             GOATS                             EXOTIC ANIMALS
GRAIN CROPS CORN (Bu)                   WHEAT (Bu)          HAY (TON)           SOYBEAN (Bu)          SILAGE (Bu)                   OTHER
PORTABLE    YEAR       WIDTH x LENGTH    PURCHASE PRICE        LANDOWNER                                                            HOW LONG AT THIS LOCATION?
 STORAGE                                 $
BLDGS/SHED
            YEAR             MAKE        WIDTH x LENGTH                             LOCATION:
 MOBILE
 HOMES      Do you own       Check one: If not, please
            real estate that  Yes    No list land owner:
            home sits on?
Failure to return your Assessment List will result in a Penalty.                        ASSESSED VALUE      PENALTY                  ASSESSED VALUE      PENALTY
                                                                                           0 – $1,000                 $15           $5,001 – $6,000               $65
        Late Personal Property Lists - Sec. 137.345 of SB 62                                $1,001 – $2,000           $25             $6,001 – $7,000             $75
      requires the assessor to assess a penalty on any person who                           $2,001 – $3,000           $35           $7,001 – $8,000               $85
                                                                                          $3,001 – $4,000             $45           $8,001 – $9,000               $95
    fails to return his personal property tax list by the first day of March.             $4,001 – $5,000             $55           $9,001 and above          $105

 Brent Johnson, Assessor                              940 N. Boonville Ave., Room                                  37   Springfield, MO 65802-3802 
 List all taxable tangible personal property belonging to or under your         Every person owning or holding tangible personal property on the first 
 control on the first day of January.                                               day of January, including all such property purchased on that day, 
                                                                                    shall be liable for taxes thereon during the same calendar year.
 Houseboats, cabin cruisers and mobile homes shall be assessed  in the 
 county where they are located.                                                    If you would like assistance, please come to the County  
                                                                                    Assessor’s Office or call (417) 868-4191.
 Mobile homes shall be personal property, (except mobile homes
   situated on land owned by the home owner shall be real property,                Are you leasing a vehicle?  
 statute 700.111.)  Missouri statute #137.115(6).                                      DO NOT Report Leased Vehicles on this list. Your leasing company will provide 
                                                                                            us with this information. 
                                                                                                                                    GREE2 - 114 (Rev 10/21)
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