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OFFICE OF THE ASSESSOR
2015 Annual Income and Expense Report
Town of Branford
Property Location: ________________________ 1019 Main St, PO Box 150
(must be completed) Branford, CT 06405-3771
TEL: 203-488-2039
Property Owner: __________________________ FAX: 203-315-3334
(must be completed)
FILING INSTRUCTIONS: The Assessor’s Office is preparing for the revaluation of all real property
located in Branford. In order to fairly assess your real property, information regarding the property income and
expenses is required. Connecticut General Statutes §12-63c requires all owners of rental real property to
annually file this report. The information filed and furnished with this report will remain confidential
in accordance with §12-63c(b), which provides that actual rental and operating expenses shall
not be a public record and is not subject to the provisions of Section §1-210 (Freedom of
Information).
Please complete and return the completed form to the Branford Assessor’s Office on or before
JUNE 1, 2016.
In accordance with Section § 12-63c(d), of the Connecticut General Statutes, as amended, any owner of rental
real property who fails to file this form or files an incomplete or false form with intent to defraud, shall be subject
to a penalty assessment equal to a Ten Percent (10%) increase in the assessed value of such property.
GENERAL INSTRUCTIONS: Complete this form for all rented or leased commercial, retail, industrial or
combination property. Identify the property and address. Provide Annual information for the Calendar
Year 2015. TYPE/USE OF LEASED SPACE: Indicate use the leased space is being utilized for (i.e., office,
retail, warehouse, restaurant, garage, etc.). ESC/CAM/OVERAGE: (Circle if applicable) ESCALATION:
Amount, in dollars, of adjustment to base rent either pre-set or tied to the Inflation Index. CAM: Income received
from common area charges to tenant for common area maintenance, or other income received from the common
area property. OVERAGE: Additional fee or rental income. This is usually based on a percent of sales or
income. PROPERTY EXPENSES & UTILITIES PAID BY TENANT: Indicate the property expenses &
utilities the tenant is responsible for. Abbreviations may be used (i.e., “RE” for real estate taxes & “E” for
electricity). VERIFICATION OF PURCHASE PRICE must be completed if the property transaction occurred
within the past three (3) years.
WHO SHOULD FILE: All individuals and businesses receiving this form should complete and return this
form to the Assessor’s Office. If you believe that you are not required to fill out this form, please call the number
listed above to discuss your special situation. All properties which are rented or leased, including commercial,
retail, industrial and residential properties, except
“such property used for residential purposes, containing not
more than six dwelling units and in which the owner resides”
must complete this form. If a property is
partially rented and partially owner-occupied this report must be filed.
IF YOUR PROPERTY IS 100% OWNER-OCCUPIED, OR 100% LEASED TO A
RELATED CORPORATION, BUSINESS, FAMILY MEMBER OR OTHER RELATED
ENTITY, PLEASE INDICATE BY CHECKING THE FOLLOWING BOX.
HOW TO FILE: Each summary page should reflect information for a single property for the year of 2015. If
you own more than one rental property, a separate report/form must be filed for each property in this
jurisdiction. An income and expense report summary page and the appropriate income schedule must be
completed for each rental property. Income Schedule A must be filed for apartment rental property and
Schedule B must be filed for all other rental properties. All property owners must sign & return this form
to the Branford Assessor’s Office on or before JUNE 1, 2016 to avoid the Ten Percent (10%)
penalty.
A COMPUTER PRINT-OUT IS ACCEPTABLE AS LONG AS ALL THE REQUIRED
INFORMATION IS PROVIDED.
RETURN TO THE ASSESSOR ON OR BEFORE JUNE 1, 2016