15 DPT-AS Form
DO NOT USE – FOR ASSESSOR ONLY
State of Colorado
DS-155 61-12
RESIDENTIAL PERSONAL PROPERTY
DECLARATION SCHEDULE
RECEIVED
(CONFIDENTIAL DATA)
COMPLETED
NO
LATE FILING PENALTY APPLIED
YES
RETURN TO COUNTY ASSESSOR
________________ County
B.A. CODE
T.A. CODE
SCHEDULE/ACCT. NO.
Assessment Date
Due Date
January 1, 2012
April 15, 2012
A. NAME AND MAILING ADDRESS (INDICATE ANY
PHYSICAL LOCATION OF THE PERSONAL PROPERTY
CHANGES OR CORRECTIONS)
AS OF JANUARY 1, 2012
Rented Area: ___________ Square Feet
B. RENTAL STATUS:
(Please check the appropriate boxes ONLY).
The assessor may select your rental property for an audit whether or not you file a declaration schedule.
NOT CURRENT OWNER. If you are not the current owner, check here and provide the name and address of the new owner:
________________________________________________________________________________________________________
Date Sold: ________________________
CHECK HERE IF NO LONGER A RENTAL. Ending rental date________________________
FIRST TIME FILER / NEW RENTAL / NEW OWNER. YOU MUST ATTACH A COMPLETE DETAILED LISTING of all
your residential personal property including the cost and month/year first rented.
EXISTING RENTAL. Indicate any additions and/or deletions to your listing in Section D.
CHECK HERE IF THERE ARE NO CHANGES FROM LAST YEAR’S DECLARATION SCHEDULE INFORMATION.
IF SO, GO DIRECTLY TO SECTION F. COMPLETE IT, SIGN IT, AND RETURN FORM TO THE ASSESSOR.
C. UNIT DESCRIPTION: Please describe your rental unit by CHECKING the appropriate boxes below.
Furnished
Unfurnished
Studio
Number of Bedrooms: ______ Bedrooms
Mobile Home
Other
**FOR THE MOST ACCURATE ASSESSMENT, IT IS RECOMMENDED THAT YOU ATTACH A COMPLETE
ITEMIZED ASSET LISTING WITH EACH RENTAL PERSONAL PROPERTY DECLARATION FILING.**
D. LISTING OF PERSONAL PROPERTY: ADDITIONS AND DELETIONS.
If NO ADDITIONS, check here; otherwise, list all personal property acquired prior to January 1. Attach additional sheets if necessary.
NOTE: List ALL personal property with a life of greater than one year and assets that are subject to IRS depreciation. Please make sure that you
declare all newly acquired, refurbished, and/or replaced furniture and appliances.
Month &
Description of Furniture, Furnishings,
Item ID
Year
Check New or Used
Your Original
Year First
Household Goods, Equipment, Art, Etc.
Number
Acquired
for Each Item:
Installed Cost
Placed into
Note the brand and model, if applicable.
Service
New
Used
$
New
Used
$
New
Used
$
If NO DELETIONS, check here; otherwise, list all personal property sold, traded, or discarded prior to January 1. Attach separate sheet(s) if needed.
Item ID
Description of Furniture, Furnishings,
Year
Check New or Used
Your Original
Number
Household Goods, Equipment, Art, Etc.
Acquired
for Each Item:
Installed Cost
Note the brand and model, if applicable.
New
Used
$
New
Used
$
New
Used
$
SEE OTHER SIDE