Annual Income And Expense Report



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Property Expenses Utilities Paid by Tenants VERIFICATION OF PURCHASE PRICE (CHECK ONE) (Complete verification section only if property transaction occurred within past three (3) years) FIXED PURCHASE PRICE FIRST MORTGAGE INTEREST RATE PAYMENT SCHEDULE TERM YEARS SECOND MORTGAGE INTEREST RATE PAYMENT SCHEDULE TERM YEARS OTHER INTEREST RATE PAYMENT SCHEDULE TERM YEARS VARIABLE DOWN PAYMENT DATE OF PURCHASE DID THE PURCHASE PRICE INCLUDE A PAYMENT FOR: FURNITURE EQUIPMENT OTHER (specify) (value) (value) (value) WAS THE SALE BETWEEN RELATED PARTIES (Circle One): YES NO WAS AN APPRAISAL USED IN THE PURCHASE OR FINANCING (Circle One): APPROXIMATE VACANCY AT DATE OF PURCHASE YES NO APPRAISED VALUE/NAME OF APPRAISER PROPERTY CURRENTLY LISTED FOR SALE (Circle One) YES NO IF YES, LIST THE ASKING PRICE DATE LISTED BROKER REMARKS – Please explain any special circumstances or reasons concerning your purchase (i.e., vacancy, conditions of sale, etc.) I DO HEREBY DECLARE UNDER PENALTIES OF FALSE STATEMENT THAT THE FOREGOING INFORMATION, ACCORDING TO THE BEST OF MY KNOWLEDGE, REMEMBRANCE AND BELIEF, IS A COMPLETE AND TRUE STATEMENT OF ALL THE INCOME AND EXPENSES ATTRIBUTABLE TO THE ABOVE IDENTIFIED PROPERTY (Section §12-63c(d) of the Connecticut General Statutes)..




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