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2. For the Calendar Year of:
   Ex. 2015
4. Information provided is confidential, in accordance with Connecticut law.
6. Property Name
8. Property Address
10. City
11. State
12. Zipcode
14. Form Preparer/Position
15. Phone Number
17. General Data
19. Golf Course Designer
21. Orientation Type

    1. Public
    2. Semi-Private

    1. Private
    2. Par-3

    1. Executive
    2. Championship
23. Number of Holes
24. Total Yardage
26. Number of Memberships
27. Single
28. Family
30. Which months comprise your winter season?
31. Which months comprise your summer season?
35. Analysis of Rounds Played
37. Member
39. Winter Season
40. Summer Season
41. Cart Rounds
42. Annual
44. Non-Member
46. Winter Season
47. Summer Season
48. Cart Rounds
49. Annual
51. Group/Tournament
53. Winter Season
54. Summer Season
55. Cart Rounds
56. Annual
58. Complimentary
60. Winter Season
61. Summer Season
62. Cart Rounds
63. Annual
65. Total Rounds
67. Winter Season
68. Summer Season
69. Cart Rounds
70. Annual
74. Fee Structure
77. Winter Season
    Include a.m. / p.m.
78. Summer Season
    Include a.m. / p.m.
79. Annual
81. Greens Fee with Cart
86. Greens Fee without Cart
91. Cart Fee
96. Prepaid Cart Fee
101. Trail
106. Typical Group / Tournament Fee
111. Initiation Fee
116. Single Membership
121. Family Membership
128. Annual Gross Income
130. Cart and Green Fees
132. Membership Income
134. Tennis Income
136. Pro-Shop & Driving Range
138. Food & Beverage Income
140. Other
143. Total
145. Less: Cost of Goods Sold
147. Tennis & Pro-Shop
149. Food
151. Beverage
153. Other
156. Income before Operating Expenses
158. Annual Operating Expenses
160. Real Estate Taxes
162. Personal Property Taxes
164. Property Insurance
166. Repairs & Maintenance*
168. General/Administrative**
170. Management Fee
172. Reserves
174. Other
     Please explain
177. Total Operating Expenses
180. Net Operating Income
182. Year End Income Summary
     Please include a copy of your year end income summary.
184. Do any of the figures include capital expenditures or extraordinary costs which vary from typical operating expenses?

     1. Yes
     2. No
186. If yes, please explain:
190. e-Signature & Position
191. Date
     Date
195. *Includes Repair and Maintenance items such as chemicals/fertilizers, grass/seed, gasoline/oil, utilities, etc.
197. **Includes General and Administrative expenses such as advertising, security, administrative payroll expenses, telephone, etc.
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199. 1. Receive an email copy of this form.
200. Email address

     This field is not part of the form submission.

201. Submit Submit and Print

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