This form provides essential market information to the county assessor to ensure accurate, fair and
uniform assessments for all property. This document is not recorded, is kept confidential, and is not
available for public inspection.
This declaration must be completed and signed by either the grantor (seller) or grantee (buyer).
Questions 1, 2, 3, and 4 may be completed (prefilled) by a third party, such as a title company or closing
agent, familiar with details of the transaction. The signatory should confirm accuracy before signing.
This form is required when conveyance documents are presented for recording. If this form is not
completed and submitted, the county assessor may send notice. If the completed and signed form is not
returned to the assessor within 30 days of notice, the assessor may impose a penalty of $25.00 or 0.025%
(0.00025) of the sale price, whichever is greater.
Additional information as to the purpose, requirements, and level of confidentiality regarding this form
are outlined in Colorado Revised Statutes, sections 39-14-102, 39-5-121.5, and 39-13-102.
1. Physical Address and/or legal description of the real property sold: Please do not use P.O. Box numbers.
2. Type of property purchased: Single Family Residential Townhome Condominium Multi-Unit Residential
Commercial Industrial Agricultural Mixed Use Vacant Land Other
Date of closing: mm/dd/yyyy
Date of contract: mm/dd/yyyy
Total Sale Price: include all real and personal property
Contracted price (if different from final sale price)
List any personal property included in the transaction that materially impacts the total sale price.
Personal property may include, but is not limited to: machinery or equipment, vehicles, exceptional appliances, electronic
devices, furniture, or anything that would not typically transfer with the real property (attach additional pages if necessary).
Description Approximate Value
Personal Property Total:
If no personal property is listed, the entire purchase price will be assumed to be for the real property.
6. Did the total sale price include a trade or exchange of additional real or personal property? No Yes
If Yes, approximate value of the goods or services as of the date of closing:
If Yes, does this transaction involve a trade under IRS Code Section 1031?
7. Was 100% interest in the real property purchased? No Yes
Mark "No" if only a partial interest is being purchased.
If No, interest purchased %
Is this a transaction between related parties or acquaintances? This includes persons connected by blood or marriage, or
business affiliates, or those acquainted prior to the transaction.