Form Dr 1303 - Gross Conservation Easement Donor Schedule - 2013
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1DR 1303 (08/19/13)
*131303==19999*
COLORADO DEPARTMENT OF REVENUE
Denver CO 80261-0005
2013 Gross Conservation Easement
Donor Schedule
Last Name or Business Name
First Name
Middle Initial
SSN
Colorado Account Number
FEIN
Required Attachments:
This form must be attached to your Colorado income
tax return if your name is on a new gross conservation
1. Federal Form 8283 / Summary of Qualified
easement Tax Credit Certificate for this year. Also attach
Appraisal
forms DR 1304 and DR 1305. A jointly filing couple should
2. Tax Credit Certificate from Division of Real Estate
only submit one of each form.
3. Complete Appraisal and Appraiser Affidavit
submitted to Division of Real Estate.
Donors filing an electronic return must submit the
4. Recorded Conservation Easement Deed.
following required attachments electronically with their
5. Title Insurance Commitment, including Schedules A
return, by email to DOR_GCEInformation@state.co.us, or
and B and vesting deeds
by mail to the address above.
Part A: Donation Information To be completed by the Donor, from federal form 8283 where applicable
1. Tax Credit Certificate Number
2. Appraised fair market value of the easement
$
3. Date you acquired the property
(MM/DD/YY)
4. How you acquired the property (e.g. purchase, gift, or inheritance)
5. Donor’s cost or adjusted basis. (For property received as a gift, refer to the grantor’s
cost basis. For inherited property, refer to the fair market value at the date of death.)
$
6. For bargain sales, enter amount received. (If the easement was donated in its entirety
then enter $0.)
$
7. Donation value, which is the total amount eligible to be claimed as a federal charitable
deduction, including any amount carried forward to future years. (The total for all donors
of this easement is the basis for calculating the Colorado credit.)
$
8. Did you make this easement donation in order to get a permit or other approval from
Yes
No
a local or other governing authority?
Part B: Easement Holder Affidavit To be completed by the organization holding the easement, but not required
if the organization is a federal agency.
9. Name of the organization holding the easement
10. Have you filed form DR 1299 in accordance with § 24-33-112, C.R.S. with both the
Yes
No
Department of Revenue and the Division of Real Estate?
11. Is this transaction part of a series of transactions by the same donor? If this is the first
donation of a planned series, check “yes” even though it is possible that the donor will
Yes
No
not make future donations.
12. Have you reviewed the completed Colorado Gross Conservation Easement Credit
Public Information Schedule, DR 1304, to be filed by the taxpayer and verified that
Yes
No
the property is accurately described there?
Under penalty of perjury, I declare that to the best of my knowledge and belief, Part B of this form is true, correct
and complete.
Print Name
Title
Telephone Number
(
)
Authorized Signature
Date
(MM/DD/YY)
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