Summit County Government Logo  Summit County Assessor
 208 Lincoln Avenue
 PO Box 276
 Breckenridge, CO 80424-0276
 p:970.453.3480
 e:personalproperty@co.summit.co.us 		2011 STATE OF COLORADO
PERSONAL PROPERTY DECLARATION SCHEDULE
(Any changes of Name, Address, Furniture, or Equipment may be made directly to this form)
DUE DATE: APRIL 15, 2011

SCHEDULE NUMBER *Required Field (7 digit number starting with a "9")
Contact the Assessor's office if you do not know your Schedule Number.
SECTION A: OWNER NAME AND ADDRESS (Indicate Any Changes)
Name of person submitting this form* Required Field
Owner First Name Owner Last Name
Legal/Corporation Name
Mailing Address
City State Zip code
SECTION B: PHYSICAL LOCATION OF THE PROPERTY
Business Type
Street Address
City State Zip code
SECTION C: CONTACT INFORMATION
Phone Number*
Required Field ex. xxx-xxx-xxxx 		Cell Phone Number
Fax Email
SECTION D: STATUS
Start-Up Date Ending Date
SECTION E: LEASED, BORROWED, OR RENTED PERSONAL PROPERTY
  • All personal property leased, borrowed, or rented by you must be listed in this section.
  • Property leased 30 days at a time or less, rented at the renter's option and for which sales/use tax is collected before it is finally sold, is considered exempt and should NOT be reported.
  • Attach additional sheets, if applicable (indicating your schedule/account number).
Lessor's Name Address Item Description
(Model or Lease number) 		Lease Start Date Lease Termination Date Date and Cost
(If purchased after Termination)
SECTION F: ALL PERSONAL PROPERTY
  • Please furnish a complete itemized list of all furniture, tools, and equipment owned by you and used in your rental/business.
  • Do not include licensed mobile equipment.
  • Submit original installed cost only (no depreciated values).
Item Description Year Acquired New/Used Original Installed Cost Year Placed In Use

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