SCHEDULE D-3—QUALIFYING TANGIBLE PERSONAL PROPERTY PURCHASED BY A CERTIFIED QHTC AND USED OR HELD FOR USE BY THE QHTC (OR LEASED UNDER A CAPITAL LEASE) TO A CERTIFIED QHTC.

SCHEDULE D-4—QUALIFYING TANGIBLE PERSONAL PROPERTY PURCHASED BY A NON QHTC AND LEASED TO A CERTIFIED QHTC UNDER A CAPITAL LEASE.

PROPERTY PURCHASE QHTC ORIGINAL REMAINING LESSOR’S NAME MONTHLY DATETYPE DATE CERTIFICATION COST COST AND ADDRESS RENT LEASE

DATE BEGAN

$ $ $

TOTAL: TOTAL:

$ $

TOTAL: TOTAL:

$ $

PROPERTY PURCHASE LESSEE’S ORIGINAL REMAINING LESSOR’S NAME MONTHLY DATETYPE DATE CERTIFICATION COST COST AND ADDRESS RENT LEASE

DATE BEGAN

$ $ $

Form FP-31 Personal PropertySchedules D-3 and D-4

, 20 and ending , 20Tax Return Year Beginning

Name

TIN

Rev. 07/19