15 DPT-AS Form
DO NOT USE – FOR ASSESSOR ONLY
State of Colorado
DS 060 95-11
PERSONAL PROPERTY
RECEIVED
LESSOR DECLARATION SCHEDULE
COMPLETED
(CONFIDENTIAL DATA)
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, 2011
April 15, 2011
A. NAME AND MAILING ADDRESS (INDICATE ANY
BUSINESS NAME AND PHYSICAL LOCATION OF THE
CHANGES OR CORRECTIONS)
PERSONAL PROPERTY AS OF JANUARY 1, 2011
B
BUSINESS: Start-Up Date (at this location
Product or Service Provided
.
)
C. BUSINESS STATUS:
(Please check the appropriate boxes ONLY).
NOT CURRENT BUSINESS OWNER. If you are not the current business owner, check here and provide the name and address of the
new owner: ___________________________________________________________________________________________________
Date Sold:
________________________
NEW BUSINESS/ORGANIZATION. You must give a complete itemized listing of all personal property. Use the first part of Section
D and attach separate sheet(s) if needed. The assessor may select your business for an audit whether or not you file a declaration
schedule.
EXISTING BUSINESS/ORGANIZATION. Indicate any additions and/or deletions to your listing in Section D.
NEW OWNER OF PREVIOUSLY EXISTING BUSINESS/ORGANIZATION. You must give a complete itemized listing of all
personal property acquired in a business purchase. Include additions made prior to Jan. 1 since that purchase.
AS OF JANUARY 1, DID YOUR BUSINESS CEASE OPERATIONS?
Yes
No
If yes, please complete below:
Personal Property Sold
Personal Property Stored
Date Sold / Stored
If sold, Selling Price of Furnishings, Assets, and Equipment Only: $____________________
If sold, Name and Contact Information of New Owner of the Personal Property: _____________________________________
_______________________________________________________________ Phone Number (_____)__________________
NOTE: If sold to more than one new owner, please attach a listing of the new owners.
PROPERTY CHANGED LOCATION TO ____________________________
ON (DATE) _______________________________
LEASED, LOANED, OR RENTED PROPERTY: ADDITIONS AND DELETIONS. Do not list licensed vehicles, mobile equipment
D.
with SMM license plates, rental decals, or Z-tabs. LOCATION AND DESCRIPTION OF PROPERTY (COMPLETE THE FOLLOWING
SECTION OR ATTACH A LIST).
If NO ADDITIONS, check here; otherwise, list all personal property acquired prior to January 1. Attach additional sheets if necessary.
NOTE: Include ALL Expensed Assets with a Life of Greater Than 1 Year, Fully Depreciated Assets Still in Use, and Stored Assets
that are Subject to IRS Depreciation.
Complete Description
Sales Price or
Month & Year
Name and Address
including Model/Serial
Lease Term
Monthly
Year
Original
First Placed
of User
Quantity
Number
(From-To)
Rent
Acquired
Installed Cost
into Service
1.
$
/each
2.
$
/each
If NO DELETIONS, check here; otherwise, list all personal property sold, traded, or discarded prior to January 1. Attach separate sheet(s)
if needed.
Complete Description
Sales Price or
Month & Year
Name and Address
including Model/Serial
Lease Term
Monthly
Year
Original
First Placed
of User
Quantity
Number
(From-To)
Rent
Acquired
Installed Cost
into Service
1.
$
/each
2.
$
/each
Purchase or maintenance options are included the total monthly rent shown above. (If checked, attach details on a separate sheet.)
SEE OTHER SIDE
PLEASE COMPLETE SECTION E