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eta. LISTING OF PERSONAL PROPERflf — Fq■ANACCUUM WEMMRsvlgAc srsi.Maw OWP=SoruLPUMU=- <br />MM- l code ALLExpmvod A WM a Ue of t3mwTbu I Yaw FWly Da reaaledA=ets StM m Use, od Asaeta WhKh PAveBoeu i* MS Depmmo n. <br />In accw1am � i 39-3 -1195, CAS. ym ne sat io e� =cfiw ir&D w l acted valm of P� pMrgd7 �o7' x71war i .8'ye ate <br />a fssttimefleraaoeeaslewla�air�eooealaeeaa tva�et+fpb� propettYperrS7119B ,Pieaseci�ecoa�yssar�rot��ea <br />deelas'a61` eclieiale,tie aeseaut�aa4ysaltedyatr basittaes�asc <br />C� ( #) List Paraonaf the p wAous year- ( S). it <br />�� ..'� - {I:♦ : {.;t': a. ? 1 3 ' ' ��', 13'G {:: i / 3 f ai .� 3+.:i44'S.; ...i ♦ -..._. t3 i- t`•..: .., _ - ,. �* - 3 <br />11. Nyou flo aPatm 4552 or 4552•Awith &MS, Please Favide aa" ofyouceoa Whod IRS €amwi* as <br />iteatiiaed listing of all paw Pn'l+ly bwbft ft &wr"M and MR af "& isrm. Note that an pasoael property that is expensed <br />A4oaM tae bciudod in ym bding. to addition. auwh a eM of the Lases dem&d Dep oei2t�a Schad ie h m your f n mcW aco da: <br />I. LEASED, LOANED, OR RENTED PROPERIY Dttgam Prap ww O--v w- by onwa poom <br />Did you bave my leased, based, orreekd macbmay, equip , , mom, Yoxftmochms , etc , at this bm = as ofhmnry l? <br />❑Yes 0 N <br />Hymebw ceelyes; list dwirma bdo *anrgtvwo s> a s> tx g y Bare a <br />is zv tatized on yow bodes acrd swords, please ci wk the box at the begnow of the limo with the =me ofdw l esm. If adMand mom is tteed4 <br />aUS& a C=4& ft liatmg of alt leased pa wad p "aty. Ifyoa clreolmd tw, go to Section to ounwiete this lam <br />Aaanerltagaa's p.ma, AAcinaa4ral� sIa tta�tet uuwb: w karnr� w�irra`r � t w. t� -mil �sw; neax <br />Lt. ft =W hap" <br />attr.o S # <br />a OHM Is i =s' <br />0 g PuRtwo, or m**mwm optbm are bxh,cied in the t M wnW $ rent show ffim% check here and fit duds. <br />J. DECLARATION TM RETURN 18 SUBJECr 7s, AUDIT <br />9 deviate under d in the wooed dogro% that this schedule, t qWw vjkh any a000mpety) eg aed0 teer olds eaets, has been aaamtnad try me and to <br />the bead aq h�. do ion, w d boM eels tvjh a W and coanplds ld d al-- , hls pownel pop oW owne m* or to my pown*n, or oaft a* <br />conM* bossed in this wixott Cdoo do on the a Renee date at this pea: that aa;h p *Wty has been rasa wd* dearxihad acts! Is value ft" mpreaw*ot and j <br />that no a Kro has been made m mislead the asssamr as to its 809, qJAV, q m". or value' # s9.6- 107 (2), C.R.S. <br />' FEDERAL EMMM 9 E3 TNIUMC iJKX4W (FMV90 ;td(. SIECfA"li/*# (SW 411, - blp 3 -70 7.(g <br />NAME OF OWNER <br />PRINT NAME OF PERSON SMNING PHONE NUMBER 9 AD ` (affi'OW <br />E- MAILMMESS FAXNtA4BER <br />'SUMUREOFOMEHORAGM LOWME � ` w f i <br />© Check hers, R new agent. r new agar*. submit a laiilar of aulhti b*don when 1*4 this torts. <br />PLEASE COIMILETE, SrN AND RETURN 70 HE ASSESSOR ON OR BEFORE APRIL 15, 2013. <br />