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• , iiiiiiiiiiiiiiiiiii t r / i i I I ~I f" ~. i- l~ w- _:? ;~ REAL PROPERTY TRANSFER DECLARATION GENERAL INFORMATION Purpose: The real property transfer declaration is used by county assessors to establish the value of real property for properly tax purposes and to properly adjust sales (or sales ratio analysis. Refer to § 39-13-102(3), C.R.S. Requirements: All conveyance documents subject to the documentary Fee submitted to the county clerk and recorder (or recordation must be accompanied by a real property transfer declaration. This declaration must be completed and signed by the grantor (seller) or grantee (buyer). Refer to § 39-14102(1)(x), C.R.S. Penalty for Noncompliance: Whenever a conveyance document is presented (or recordation without the declaration, the clerk and recorder notifies the county azsessor, who will send a written notice to the grantee requesting that the declaration be returned within . thirty days. Failure by the grantee to submit the declaration may result in the assessor imposing a penalty of $25.00 or .025°6 (.00025) of the sale price, whichever is greater. This penalty may be imposed (or any subsequent year [hat the grantee tails to submit the declaration, until the property is conveyed again. All unpaid penalties are certified to the county treasurer for collection. Refer [o § 39-13.102(I)(b), C.R.S. Confidentiality: Any information used by the assessor to determine the actual value of real property, including information derived from the real property transfer declaration is available to any taxpayer or any agent o:` such taxpayer Subject [o Confidentiality requirements as provided by law. The assessor a required !o make the declaration available (or inspecticn by the buyer or the seller IF the seller filed the declaration. I I. Address Or legal deSCtip[i0n Of real property: Enter [hz correct svee[ address or legal description of the real property. Do no[ use mailing addresses or P.O. box numbers. The Southwest ; of the Southeast of Section 17, 'Ibwnship 14 South, Fange 78 West of the 6th Principal A'~ridian >.n ee Cottnty, o ore o. Together with a 60 foot wide roadway ease3rent across the S , of S , of said Section 17, said roadway easetrent to adjoin the entire south boundary of the sail o an o en e ~ wi 3~rt a no er y irec ion rom e I ou~}t boluldar~. 2.~5 t t5 a [ransac on among related parties? Indicate whether [he buyer or the seller were related. Related parties include persons within the same (amity, businzss afftl[ates. or aff[hated corporavons. Yes^ Nod 3. TOI3I Sale price: Indn:ate the total cousidtra[ion paid (or the property including real estate, personal property tcarpeung, drapzs, appliances, inventory, equipment, (urmturz), mobilz homes, shads. goodwill, water rights. mineral rights, and any other appurtenances. $ sn^ooo.oo 4. What was the Cash down payment? Enter thz amount oFthz cash down payment, if any. If it is a cash sale, enter the total sales prier. I $17.00 5. Did total sale price include a trade or exchange' Indicate whether any other real or personal property was traded Or exchanged as part of the Transaction. For example, mark "Yes" IFa vacant lo[ was traded as the down payment or i(the salt included an amount (or repair o([he roof. Yes ® No ^ 6. Did the buyer receive any personal property in the transaction? Indicate i(any personal properly, as described in pl, was included in the total sales price. If yes, give the approximate value as o(the date of the sale: Yes ^ No ® If yes, the approximate value: $ 7. Were mineral rights included in the sale? Indicate IF any portion of the mineral rights were transferred to the grantee. Mineral right is defined az an interest in minerals in and under the land and all accompanying rights and privileges. Yes^ No® $. Were Water fights Included in the sale? Indicate i(any water rights were transferred to [he grannie. Water right is defined as the right to use the water o(a natural stream or water furnished through a ditch or canal, for Such purposes as irtigation, mining, power, or domestic use. Water rights are real property which may be sold and transferred separately From the land. Yes ^ No ~ 2D D 3 No. 1181. Rer. 2-9U. REAL PROPERTY TRANSFER DECLdRAT10N OS-DPT AD/FORM TDIUOU?/9d) Brad(urJ PubLSM1mq, 11J] Wozce A_ Denver. C0 a0?0'_-pOD'9+ :500- 5-VO