Town of Salisbury Assessor’s Office
Town of XXXXX Assessor’s Office
Automobile – Related Commerical Properties
Income and Expense Survey for Calendar Year 2____
Information provided is CONFIDENTIAL, in accordance with Connecticut Law.
Business Name (if applicable) _________________________________________________________
Property Address _________________________________________________________
Form Preparer/Position _________________________________________________________
Telephone Number _________________________________________________________
Type of Business
( New Car Dealership (Full Service) ( Gasoline Service Station & Repair
( Used Car Dealership (Full Service) ( Gasoline Service Station & Retail
( Used Car Dealership (Limited Service) ( Auto Repair
Total Leased Building Area
% finished (office, showroom, retail) _________________ Sq. Ft.
% service/shop _________________ %
% warehouse/storage _________________ %
Is total land area of property addres included in lease? Yes ( No (
If not, how much is included? _________________ Sq. Ft.
Annual base rent for 2____ $ _______________
Additional rent (%, overage, etc.) $ _______________
Total Rental Income for 2___ $ _______________
Operating Expenses paid by Landlord Tenant
Real Estate Taxes $ _______________ $ _______________
Insurance $ _______________ $ _______________
Repairs & Maintenance $ _______________ $ _______________
Administrative, Legal, Accounting $ _______________ $ _______________
Reserves $ _______________ $ _______________
Utilities $ _______________ $ _______________
Trash/Snow Removal $ _______________ $ _______________
Total Operating Expenses $ _______________ $ _______________
For additional comments and/or information (original lease term, escalation rates, renewal options, purchase option, etc.), please attach a separate page.
_______________________________________/______________________________________________
Signature/Position Date
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