Form Dr 1299 - Colorado Gross Conservation Easement Holders Submission Of Information
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1Departmental Use Only
DR 1299 (11/22/10)
COLORADO DEPARTMENT OF REVENUE
DENVER, CO 80261-0005
COLORADO GROSS CONSERVATION EASEMENT
HOLDERS SUBMISSION OF INFORMATION
Organization Name
Colorado Revenue Acct. Number
Period
01/10-12/10
0156-750(999) $0.00
A. Number of conservation easements held by the organization in Colorado ________________________
B. List the acreage for each conservation easement held in Colorado. Do not include any properties for which the sole conservation purpose is
historic preservation. Attach a schedule if additional space is needed.
Conservation Easement
# of Acres
Conservation Easement
# of Acres
1.
5.
2.
6.
3.
7.
4.
8.
Total acreage of conservation easements held by this organization ___________________________________
C. If the organization is a private nonprofit organization, list the names of the board members. If the organization is a public entity, list the names of the
elected or appointed officials. Attach a schedule if additional space is needed.
Date
D. Date on which the organization received certification from the Division of Real Estate pursuant to
Section 12-61-720, C.R.S.
I declare that this organization has a commitment to protect the conservation purpose of each conservation easement donation and has the
resources to enforce the restrictions. Also, I declare that this organization has adequate resources and policies in place to provide annual
monitoring of each conservation easement held by the organization in Colorado, except for any conservation easement granted to a local
government that did not involve a charitable donation.
Authorized Signature
Date
Title
Telephone Number
Every charitable organization or governmental agency that accepts a conservation easement in gross in Colorado during the
year must file this form no later than April 15 of the following year. However, the report must be filed prior to accepting any
new conservation easement donation during the calendar year. Report all conservation easements held in Colorado on this
form, not just those donations received during the prior year. Copies of the completed form are available to the public from
the Department of Revenue or Division of Real Estate.
Mail signed copies of the completed form to both of the following State Departments:
Colorado Department of Revenue, Denver CO 80261-0005
Contact: or (303) 238-7378
Colorado Division of Real Estate, 1560 Broadway, Suite 925, Denver CO 80202
Contact: or (303) 894-2166
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