Form Dr 1304 - Colorado Gross Conservation Easement Public Information Schedule (Page 2 of 2) in pdf

Form Dr 1304 - Colorado Gross Conservation Easement Public Information Schedule Page 2

Taxpayer Name

Social Security Number or Colorado Account Number

Tax Year of Donation

Appraised Value of Easement

Donated Value of Easement

A. Are you the donor of the conservation easement?

Yes

No, the donor is a pass-through entity

(If no, complete question B. If yes, complete question C.)

B. Who is the donor of the conservation easement?

Name

Colorado Account Number

C. Were you the Sole Donor?

Yes

The property is jointly owned by: _________________________________________________________

_________________________________________________________

Under penalties of perjury, I declare that to the best of my knowledge and belief, this return is true, correct,

and complete.

Signature of taxpayer or authorized officer

Date

Title, if signed by authorized officer

Telephone Number

All information provided on the front of this form is public information and can be viewed at

Members of a pass-through entity must enter on line 5 their share of the total credit claimed on the donation.

The donor of a gross conservation easement (including a pass through entity and each shareholder, partner, or

member) must submit this form under separate cover from the Colorado income tax return for the tax year the

donation was made. To expedite processing of refunds associated with this credit, file this form electronically

instead of mailing this paper form. Transferees of the credit

should not file this form.

Submit electronically or mail the completed form to:

Colorado Department of Revenue

Conservation Easement Section

Denver CO 80261-0005

Form Dr 1304 - Colorado Gross Conservation Easement Public Information Schedule Page 2