15 Dpt-As Form Ds 056 - Personal Property Declaration Schedule - 2014 Page 2
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2E. MOBILE EQUIPMENT (Not Leased, Loaned, or Rented)
Check here and complete this section if there is any mobile equipment at this location.
Item
Licensed /
Year
Check New or Used
Your
Year
ID Number
Description / Model or Capacity
Z-Tabbed?
Acquired
for Each Item:
Installed Cost
In Use
$
New
Used
$
New
Used
$
New
Used
DO NOT USE FISCAL YEAR BALANCES
F. GENERAL LEDGER (original installed costs only)
Do not list mobile equipment with SMM license plates, rental decals, or Z-tabs.
Machinery &
Capitalized
Electronic
Furniture
Computers
Signs
All Other
Equipment
Mobile Equipment
Office Equipment
BALANCE
JAN. 1, 2013
BALANCE
JAN. 1, 2014
G. FULLY DEPRECIATED ASSETS / EXPENSED ITEMS: Attach a separate sheet including the appropriate Federal Forms
denoting all fully depreciated assets and expensed items. If you have none, write “None.”
Year
Year
Description
Acquired
Cost
Description
Acquired
Cost
1.
$
4.
$
2.
$
5.
$
3.
$
6.
$
H. LEASED, LOANED, OR RENTED PROPERTY
Declare Property Owned by Others.
Did you have any leased, loaned, or rented machinery, equipment, furniture, signs, vending machines, etc., at this location on January 1?
Yes
No
If you checked yes, list the items below, showing owner’s name, address, and telephone number; property description; etc. If any of the leased equipment
listed is capitalized on your books and records, please check the box at the beginning of the line corresponding with the name of the Lessor. If additional
room is needed, attach a complete listing of all leased personal property. If you checked no, go to Section I to complete this form.
Original
Description Including Model/
New or
Total
Term
Installed
Owner/Lessor’s Name, Address, Tele. No.
Serial No. or Capacity
Used?
Cost of Lease
Lease Number
(From - To)
Annual $ Rent
Cost
H.1. Personal Property
New
Used $
$
$
New
Used
New
Used $
$
$
Licensed /
H.2. Mobile Equipment
Z-Tabbed?
New
Used $
$
$
New
Used $
$
$
If purchase or maintenance options are included in the total annual $ rent shown above, check here and furnish details.
I. IS THERE ANY RENEWABLE ENERGY PROPERTY (e.g., solar panels, wind turbines, hydroelectric property) AT THIS
LOCATION?
Yes
No, IF YES, THE PROPERTY IS:
Owned
Leased, IF OWNED, COMPLETE THE DS 058 FORM.
J. DECLARATION
THIS RETURN IS SUBJECT TO AUDIT
“I declare, under penalty of perjury in the second degree, that this schedule, together with any accompanying exhibits or statements, has been examined by
me and to the best of my knowledge, information, and belief sets forth a full and complete list of all taxable personal property owned by me, or in my
possession, or under my control, located in this county, Colorado, on the assessment date of this year; that such property has been reasonably described and
its value fairly represented; and that no attempt has been made to mislead the assessor as to its age, quality, quantity, or value.” § 39-5-107(2), C.R.S.
_________
PROPERTY OWNER'S FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN)/SOCIAL SECURITY NUMBER (SSN)
NAME OF OWNER ___________________________________________________________________________________________
PRINT NAME OF PERSON SIGNING ____________________________________PHONE NUMBER _______________________
E-MAIL ADDRESS ___________________________________________________FAX NUMBER ___________________________
SIGNATURE OF OWNER OR AGENT ___________________________________________DATE __________________________
Check here if new agent. If new agent, submit a letter of authorization when filing this form.
PLEASE COMPLETE, SIGN AND RETURN TO THE ASSESSOR ON OR BEFORE APRIL 15, 2014.
MAKE A COPY FOR YOUR RECORDS.
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