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Home My WebLink About20193148.tiffAugust 6, 2019 Petitioner: MORALES LEWIS D LLC 3025 8 THAVE EVANS, CO 80620-1203 CLERK TO THE BOARD PHONE (970) 400-4226 FAX (970) 336-7233 WEBS ITE: www.weldqov.com 1150 O STREET P.O. BOX 758 GREELEY CO 80632 Agent (if applicable): RE: THE BOARD OF EQUALIZATION 2019, WELD COUNTY, COLORADO NOTICE OF DECISION Docket 2019-3148 Appeal 2008224960 Hearing 8/5/2019 Dear Petitioner: On the day indicated above, the Board of County Commissioners of Weld County Colorado convened and acting as the Board of Equalization, pursuant to C.R.S. §39-8-101 et seq., considered petition for appeal of the Weld County Assessor's valuation of your property described above, for the year 2019. Account # Decision The Assessment and valuation is set as follows: Actual Value as Actual Value as Set by Determined by Assessor Board R7130298 Stipulated - Approved Stipulated Value $3,141,500 $3,141,500 A denial of a petition, in whole or in part, by the Board of Equalization must be appealed within thirty (30) days of the date the denial is mailed to you. You must select only one of the following three (3) options for appeal: 1. Appeal to Board of Assessment Appeals: You have the right to appeal the County Board of Equalization's decision to the Colorado Board of Assessment Appeals. A hearing before that Board will be the last time you may present testimony or exhibits or other evidence, or call witnesses in support of your valuation. If the decision of the Board of Assessment Appeals is further appealed to the Court of Appeals pursuant to C.R.S. §39-8-108(2), only the record of proceedings from your hearing before the Board of Assessment Appeals and your legal brief are filed with the appellate court. All appeals to the Board of Assessment Appeals filed after August 10, 2019, MUST comply with the following provisions of C.R.S. §39-8-107(5): (5)(a)(I) On and after August 10, 2019, in addition to any other requirements under law, any petitioner appealing either a valuation of rent -producing commercial real property to the Board of Assessment Appeals pursuant to C.R.S. §39-8-108(1) or a denial of an abatement of taxes pursuant to C.R.S. §39-10-114 shall provide to the County Board of Equalization or to the Board of County Commissioners of the County in the case of an abatement, and not to the Board of Assessment Appeals, the following information, if applicable: (A) Actual annual rental income for two full years including the base year for the relevant property tax year; (B) Tenant reimbursements for two full years including the base year for the relevant property tax year; (C) Itemized expenses for two full years including the base year for the relevant property tax year; and (D) Rent roll data, including the name of any tenants, the address, unit, or suite number of the subject property, lease start and end dates, option terms, base rent, square footage leased, and vacant space for two full years including the base year for the relevant property tax year. (II) The petitioner shall provide the information required by subparagraph (I) of this paragraph (a) within ninety days after the appeal has been filed with the Board of Assessment Appeals. (b)(I) The Assessor, the County Board of Equalization, or the Board of County Commissioners of the County, as applicable, shall, upon request made by the petitioner, provide to a petitioner who has filed an appeal with the Board of Assessment Appeals not more than ninety days after receipt of the petitioner's request, the following information: (A) All of the underlying data used by the county in calculating the value of the subject property that is being appealed, including the capitalization rate for such property; and (B) The names of any commercially available and copyrighted publications used in calculating the value of the subject property. (II) The party providing the information to the petitioner pursuant to subparagraph (I) of this paragraph (b) shall redact all confidential information contained therein. (c) If a petitioner fails to provide the information required by subparagraph (I) of paragraph (a) of this subsection (5) by the deadline specified in subparagraph (II) of said paragraph (a), the County may move the Board of Assessment Appeals to compel disclosure and to issue appropriate sanctions for noncompliance with such order. The motion may be made directly by the County Attorney and shall be accompanied by a certification that the County Assessor or the County Board of Equalization has in good faith conferred or attempted to confer with such petitioner in an effort to obtain the information without action by the Board of Assessment Appeals. If an order compelling disclosure is issued under this paragraph (c) and the petitioner fails to comply with such order, the Board of Assessment Appeals may make such orders in regard to the noncompliance as are just and reasonable under the circumstances, including an order dismissing the action or the entry of a judgment by default against the petitioner. Interest due the taxpayer shall cease to accrue as of the date the order compelling disclosure is issued, and the accrual of interest shall resume as of the date the contested information has been provided by the taxpayer. Appeals to the Board of Assessment Appeals must be made on forms furnished by that Board, and must be mailed or delivered within thirty (30) days of the date the denial by the Board of Equalization is mailed to you. The address and telephone number of the Board of Assessment Appeals are: Board of Assessment Appeals 1313 Sherman Street, Room 315 Denver, Colorado 80203 Telephone Number: (303) 864-7710 Email: baa@state.co.us Fees for Appeal to the Board of Assessment Appeals: A taxpayer representing himself is not charged for the first two (2) appeals to the Board of Assessment Appeals. A taxpayer represented by an attorney or agent must pay a fee of $101.25 per appeal. OR 2. Appeal to District Court: You have the right to appeal the decision of the Board of Equalization to the District Court of the county wherein your property is located: in this case that is Weld County District Court. A hearing before The District Court will be the last time you may present testimony or exhibits or other evidence, or call witnesses in support of your valuation. If the decision of the District Court is further appealed to the Court of Appeals pursuant to C.R.S. §39-8-108(1), the rules of Colorado appellate review and C.R.S. §24-4-106(9), govern the process. OR 3. Binding Arbitration: You have the right to submit your case to binding arbitration. If you choose this option, the arbitrator's decision is final and you have no further right to appeal your current valuation. C.R.S. §39-8-108.5 governs this process. The arbitration process involves the following: a. Select an Arbitrator: You must notify the Board of Equalization that you will pursue arbitration. You and the Board of Equalization will select an arbitrator from the official list of qualified people. If you cannot agree on an arbitrator, the District Court of the county in which the property is located (i.e. Weld) will select the arbitrator. b. Arbitration Hearing Procedure: Arbitration hearings are held within sixty (60) days from the date the arbitrator is selected, and are set by the arbitrator. Both you and the Board of Equalization are entitled to participate in the hearing. The hearing is informal. The arbitrator has the authority to issue subpoenas for witnesses, books, records documents and other evidence pertaining to the value of the property. The arbitrator also has the authority to administer oaths, and determine all questions of law and fact presented to him. The arbitration hearing may be confidential and closed to the public if you and the Board of Equalization agree. The arbitrator's decision must be delivered personally or by registered mail within ten (10) days of the arbitration hearing. c. Fees and Expenses: The arbitrator's fees and expenses are agreed upon by you and the Board of Equalization. In the case of residential real property, the fess may not exceed $150.00 per case. For cases other than residential real property, the arbitrator's total fees and expenses are agreed to by you and Board of Equalization, but are paid by the parties as ordered by the arbitrator. If you have questions concerning the above information, please call me at (970) 400-4226. Very truly yours, BOARD OF EQUALIZATION Esther E. Gesick Clerk to the Board Weld County Board of Commissioners and Board of Equalization cc: Brenda Dones, Weld County Assessor COUNTY BOARD OF EQUALIZATION WELD COUNTY Single County Schedule Number R7130298 STIPULATION (As To Tax Year 2019 Actual Value) RE PETITION OF NAME MORALES LEWIS D LLC ADDRESS 3025 8TH AVE EVANS, CO 80620-1203 Petitioner (s) and the Weld County Assessor hereby enter into this Stipulation regarding the tax year 2019 valuation of the subject property, and jointly move the Board of Equalization to enter its order based on this Stipulation Petitioner (s) and Assessor agree and stipulate as follows 1 The property subject to this Stipulation is described as EVS SG L13-14 AMENDED SOUTHGATE SUB 2 The subject property is classified as Commercial property 3 The County Assessor originally assigned the following actual value to the subject property for the tax year 2019 Total $3,141,500 4 After further review and negotiation, Petitioner (s) and Weld County Assessor agree to the following tax year 2019 actual value for the subject property Total $3,141,500 5 The valuation, as established above, shall be binding only with respect to tax year2019 6 Brief narrative as to why the reduction was made Changing occupancy from 100% commercial to 80% commercial and 20% residential based on 2018 sales tax receipts 7 Both parties agree that , IZIThe hearing scheduled before the Board of Equalization on 08/02/2019 at 1 30 PM be vacated nA heanng has not yet been scheduled before the Board of Equalization 1 0O(R- 3(`'153' "50(03 DATED this 23rd day of July 2019 Danush Bozorapour DalIUSF Bozorgpour (Jul Petitioner(s) or Agent or Attorney Address: 3090 S. Jamiaca Ct., Ste 204 Aurora, CO 80014 Telephone: 303-368-0500 Docket Number R7130298 St i p-1. Frm L-tintA4A4 pe7i)n-le (Assistant) County Attorney for Respondent, Weld County Board of Commissioners Address: 1150 "O" Street P.O. Box 758 Greeley, CO 80632 Telephone:(970) 336-7235 Riancict_Donth County Assessor Address: 1400 N.17th Avenue Greeley, CO 80631 Telephone: (970) 400-3650 R7130298/Morales Final Audit Report 2019-07-24 Created: 2019-07-23 By: Courtney Anaya (canaya@co.weld.co.us) Status: Signed Transaction ID: CBJCHBCAABAA_i0eVMODvI67nI5m8IGkOXV7agDQjBGJ "R7130298/Morales" History 45 Document created by Courtney Anaya (canaya@co.weld.co.us) 2019-07-23 - 9:46:15 PM GMT- IP address: 204.133.39.9 L4 Document emailed to Courtney Anaya (canaya@co.weld.co.us) for approval 2019-07-23 - 9:46:16 PM GMT £5b Document approved by Courtney Anaya (canaya@co.weld.co.us) Approval Date: 2019-07-23 - 9:46:26 PM GMT - Time Source: server- IP address: 204.133.39.9 Document emailed to Tim Reddick (treddick@weldgov.com) for approval 2019-07-23 - 9:46:28 PM GMT Email viewed by Tim Reddick (treddick@weldgov.com) 2019-07-23 - 9:47:24 PM GMT- IP address: 204.133.39.9 b© Document approved by Tim Reddick (treddick@weldgov.com) Approval Date: 2019-07-23 - 9:52:47 PM GMT - Time Source: server- IP address: 204.133.39.9 Document emailed to Brenda Dones (bdones@co.weld.co.us) for signature 2019-07-23 - 9:52:48 PM GMT Email viewed by Brenda Dones (bdones@co.weld.co.us) 2019-07-23 - 9:53:44 PM GMT- IP address: 204.133.39.9 .'=%o Document e -signed by Brenda Dones (bdones@co.weld.co.us) Signature Date: 2019-07-23 - 10:17:48 PM GMT - Time Source: server- IP address: 204.133.39.9 Document emailed to Dariush Bozorgpour (propertytax@cotaxes.net) for signature 2019-07-23 - 10:17:49 PM GMT Email viewed by Dariush Bozorgpour (propertytax@cotaxes.net) 2019-07-23 - 10:20:53 PM GMT- IP address: 172.58.62.200 Adobe Sign Document e -signed by Dariush Bozorgpour (propertytax@cotaxes.net) Signature Date. 2019-07-24 - 3:37:13 PM GMT - Time Source: server- IP address: 96.76.161.42 L?, Document emailed to Karin McDougal (weld-cboe@weldgov.com) for signature 2019-07-24 - 3:37:14 PM GMT Email viewed by Karin McDougal (weld-cboe@weldgov.com) 2019-07-24 - 3:40:35 PM GMT- P address: 204.133.39.9 Document e -signed by Karin McDougal (weld-cboe@weldgov.com) Signature Date: 2019-07-24 - 3:41:04 PM GMT - Time Source: server- IP address: 204.133.39.9 Q Signed document emailed to Brenda Dones (bdones@co.weld.co.us), canaya@weldgov.com, Dariush Bozorgpour (propertytax@cotaxes.net), Karin McDougal (weld-cboe@weldgov.com), and 2 more 2019-07-24 - 3:41:04 PM GMT 4111111119 Adobe Sign 07/01/2019 15:44 9703561910 SELECTSTAY PAGE 02/02 *57 004 Brenda pones Weld County Ass sor 1400 N 17Th Ave Greeley, CO 80631 FF�� ;lfi r•h ', r� 1�tie d ' 1f^9 ��'}{�Q�. �ri•.r ;m0.1 201E , � i. 5962 .! t' j ^ .p a lea M3; -� i', EVS SG L13.14 AMENDED S0UTHGATE SUB 3025 8TH AVE EVANS R7130298 a A as 5� �✓llf,i At ttl'1 , Ayt�,i, is ��?� p'+�i+,.�,-A Idy rI]d1.1e MORALES LEWI 3025 9 THAVE EVANS, CO 8062 11203 D LLC :+xi ° ., F �..��'�� ♦� � 9 lid aM .,6 „�l�Y YIP: ,y �,,Y,,{.r :Jr. R dbi 'r ,n` �i k'� � ._�I�`d P�NI l _MT1 �i.x?��Y� hL �� Ri #4ll Jv ,, �j d �.. t wr - •�,ikpaq. - I s(, t�.l] 5 �.. + Y °J h-� G I I. K , COMMERCIAL 3,141,500 3,141,500 fgri �R; : � 'rt`.A" "h°.. '; 3,141,500 a,14t50o NOTICE OF DETERMINATION RECEIVED JUL 1 7 2619 WELD COUNTY COMMISSIONERS Date of Notice: 8/25/2019 Telephone: (970) 400-3650 Fax: (970) 304-6433 Office Hours: 8:00AM — 6:00PM The Assessor ha specifics included the following: CM06 - The Ass value. Baca If you dieagre Boarw The Assessor est, fire protection, en authority is based the services it pro^ if you are canoel Please refer to las Please refer to th Agent (If Apoll Ca carefully studied all available information, giving particular attention to the n your protest. The Assessor's determination of value after review is based on ssor staff has requested additional information to property review your property's se we have not received this information, we have no choice out to deny any adjustments. with the Assessor's decision, you have the right to appeal to the County of Equalieatlon for further consideration, § 33-6-106(1)10), C.R.S. - ..�_... A p . The Headline far #0in real roperty appeals is July 15, blishes property values. The local taxing authonties (county, school district, city, I other special districts) set mill levies. The mill levy requested by each taxing on a projected budget and the property tax revenue required to adequately fund ides to its taxpayers. The local taxing authorities hold budget hearings in the fall. red about mill levies, we recommend that you attend these budget hearings. year's tax bill or asic your Assessor for a listing of the local taxing authorities. reverse side of this notice for additional information. le): 2019-3148 16 -OPT -AIR PR 207-08/13 R7130298 It5O1o3 06/27/2019 14:48 9703561918 SELECT5TAY PAGE 03/04 ., � �i?��.i.li,:e:..:,....4�r9�•� •I ;°3is �Eii'' ; ,-:ii'r ::yetik�,h ' ... .. ;i h.. rid•. 'i" o4r{,1,�,. {.. ';} lie `� Ali aYk it,d �.'i.td F �.;i �'. l . r,��S.� � r. yF�Ti 9of �. yl 1.�5l�ryr�L•��. ��ir�� 1:!�E�ti ��. I To appeal the Assessor's below, and mail, file To preserve your postmarked or delivered appeal is lost. Yc recommend that all You will be natifiec Equalization must nail decision. The County 5, § 39-8-107(2), C.E.S. you wish to continue September 10, § 39-2-125(1)(e), If you are dissatisfied appeal, you must appeal the following: Board of Assessment County Board of Equalization Hearings will be held from July 2Ss' through August 5th at 1'150 O Street. decision, complete the Petition to the County Board of Equalization shown online, or deliver a copy of both sides of this form to: Weld County Board of Equalization 1150 O Street, P.O. Box 756 Greeley, CO 80631 Telephone: (970) 356-4000 ext, 4225 Online: WWwca.we1d.co.us/appsllcboe/ ippeal rights, your Petition to the County Board of Equalization must be on or before July 15 for real property — after such date, your right to u may be required to prove that you filed a timely appeal; therefore, we correspondence be mailed with proof of mailing. of the date and time scheduled for your hearing. The County Board of a written decision to you within five business days following the date of the Board of Equalization must conclude hearings and render decisions by August If you do not receive a decision from the County Board of Equalization and your appeal, you must file an appeal with the Board of Assessment Appeals by C.R.S. with the County Board of Equalization's decision and you wish to continue your within 30 days of the date of the County Board's written decision to ONE of Appeals District co,u 1313 Sherman Street, Denver, CO 80203 (303) 856.5880 www.dola,colorado.c Room 315 Contact the District Court in the County where the property is located. See your local telephone book for the address and ovlbaa telephone number. Blndlno Arbitration contact the County Commissioners et the address listed for the County Board report, schedule, claim, tax return, statement, remittance, or other document Sunday, or legal holiday, it shall be deemed to have been timely filed if filed day, § 39-1.120(3), C.R.S. For a list of arbitrators, of Equalization. if the date for filing any falls upon a Saturday, on the next business -.;;.;,*5!.i7$ .f 4 :M'•' �. sa',I '� - a i • �..� T.. e.,...�. i^r 1 i ll- 'A/r;�.. I':� < , ,- �. , ' ti - j�. r ` 3. �t' r Fay ARM. -F iE'Q'l Af 'flOi#�a ,': :;IF What is your estimate specjIic dollar amount $ ``-S r 1l of the property's value as of June 30, 2018? (Your opinion of value in terms of a s required for real property pursuant to § 39-8-106(1.5), C.R.S.) your estimate of value or your reason for requesting a review? (Please attach ecessary and any supporting documentation, i.e., comparable sales, rent roll, original etc.) / IL 1.,L.cki_oe 0 a[�Selu,w.,-/- `_ ir'`'e k�{.5 r./ What is the basis far additional sheets as r installed cost. appraisal, .,�r T� ��;, r i:!. + 'fi �, :.,; �K., ra�R,y�!��y,�f-lam,.. �� f „syY l , � � r �` S r!E"Z i xx yy�� >! '$MI 7 : _ $C S '' �1 a : 1 F..V 11.� 1 i. i. 4 �u� �`Ji:",`S;�i�.n. }.im�ts t. �n1 ��5�4M-C».. x..,y.. � � a l .. r>�..1, �., in3aP .t ylr7 �y�:',! t1,I �E,: � -; I, th undersigned owner n any attachmen or agenl1 of the property identified above, affirm that the statements contained herein s hereto are true and complete_en ,,7 ---, 3^ 34E- o br `714117 ignalure f (Ci Telephone Number Date ��11 i*le 97 1"-' 1 Tax P �yAdvisors, Inc. 3090 S. Jamaica Ct., #204 Email Address 1 Attach letter of autho ization signed by property owner. Aurora, CO 80014 15 -OPT -AR Tel: 303.368.0500 PR 7° 30290 Email: propertytax@cotaxes.net EST NINETEEN HUNDRED ft EIGHTY SEVEN pI9PEfl'CT TA! ADVISORS Ift . Special'ziny 919 Carol -ado GOn1Me!•ciaJ 5'inper y .rler TI-olesis July 12, 2019 Weld County Board of Equaliz Lion PO Box 758 Greeley, CO 80631 To Whom It May Concern: RECEIVED JUL 1 7 2019 WELD COUNTY COMMISSIONERS Enclosed are 2019 protests. Please date stamp the attached list of filings and fax, email or mail back to: Property Tax Advisors, Inc. 3090 S. Jamaica Ct., #204 Aurora, CO 80014 Fax: (303)368-0573 Email: propertytax@cotaxes.net Thank you in advance for your attention to this matter. Best regards, Christine Rauch Office Manager propertytax§7cotaxes net p 303.356.0500 f. 303.368.0573 3090 S. Jamaica Court, Suite +1204 Aurora, Colorado 36014 www.property-tax-advisors.com ICE Flings PTA Flle# Schedule # County Property0wcor PropertyAddress 5697 R7130298 Weld Morales, Lewis ID. LLC 3025 8th Ave. 8132Q R2459786 Weld Willow Apartments Ltd. 2601 23rd Ave. Wednesday, July 10, 2019 Page 1 of 1 Agent: PROPERTY TAX ADVISORS, INC. 3090 South Jamaica Court, Suite 204 Aurora, Colorado 80014 Tel: 303.368.0500 Fax: 303.368.0573 Email: propertytax@cotaxes.net Subject: APPEAL OF REAL PROPERTY VALUATION Tax Year: 2019 County: Weld Schedule Number: R7130298 Property Address: 3025 8th Ave. Property Owner: Morales, Lewis D. LLC Mailing Address: 3025 8th Ave. Evans, CO 80620 Inclusions: Report Date: 7/10/19 Photograph(s) of Subject Property Correlation and Conclusions Income Approach Market Sales Cost Approach Salient Facts OWNER OCCUPIED PETITIONER'S FINAL ESTIMATE OF VALUE: ASSESSOR'S VALUE,: ** ** ** Please see salient fact sheet PTA # 5697 Site Size s,f. YOC Effective Bldg. Age (yrs) Gross Building Area s.f, Remaining Econ. Life (yrs) Land to Bldg. Ratio :1 Zoning Construction Use: Motel SALIENT FACTS It is requested that 20% of actual value be assessed at the residential rate. 2019 January February March April May June July August September October November December Total Total Revenue 30 -Day Stay Revenue $ 50,898 $ 6,980 $ 58,735 $ 8,580 $ 92,915 $ 7,528 $ 91,024 $ 10,235 $ 95,890 $ 9,735 $ 92,175 $ 11,000 $ 103,567 $ 15,514 $ 105,232 $ 16,413 $ 102,576 $ 23,955 $ 104,447 $ 37,165 $ 94,406 $ 39,221 $ 77,103 $ 29,427 $ 1,068,968 $ 215,753 % Revenue from 30 -Day Stays 20.18% Taxpayer Name and Address CITY OF EVANS SALES AND USE TAX RETURN Mail To: Sales Tax Division Email: salestax@ci.evans,co.us Dept. 2324 Phone: (970) 475-1109 I Denver, CO 80291-2324 Fax: (970) 475-1194 6ea4-----COLDROD Lewis D Morales, LLC DBA Select Stay Hotel 3025 8th Avenue Evans CO 8O62O YOU MUST FILE THIS RETURN EVEN IF LINE 12 Is ZERO PERIOD COVERED DUE DATE ACCOUNT # January 2018 O2/2O/18 O5O729 COMPUTATION OF SALES TAX _ - _ _ GROSS SALES AND SERVICES: (BEFORE SALES TAX) MUST BE REPORTED INCLUDING ALL SALES, RENTALS, LEASES, AND SERVICES, BOTH TAXABLE AND NON-TAXABLE_ $ 50,898 $ 1,537 ADD BAD DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED: $ 6 ADD EXCESS TAX COLLECTED $ ADD LINES 1 & 2A $ 50,898 7 NET ADJUSTED SALES TAX {ADD LINES 5 & 6} 3 A. NON TAXABLE SERVICES OR LABOR $ $ DEDUCT 3.33% OF LINE 7 (ENTER 0 IF RETURN IS FILED LATE) "MAXIMUM AMOUNT ALLOWED is $100" $ 51 B. SALES TO OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE — TOTAL SALES TAX DUE (LINE 7 MINUS LINES) $ 1,486 C, SALES SHIPPED OUT OF THE CITY QF EVANS $ W LATE FEES DUE IF FILED AFTER DUE DATE PENALTY: GREATER OF $15 OR ..,"ID-ta OF LINE 9 $ PUT TOTAL BELOW — D. BAD DEBTS CHARGED OFF {ON WHICH CITY TAX WAS PREVIOUSLY PAID} © INTEREST: .75% PER MONTH OF LINE 9 $ $ E. TRADE-INS FOR TAXABLE RESALE $ 11 PRIOR PERIOD ADJUSTMENT FOR OVER OR UNDERPAYMENTS $ F. SALES OF GASOLINE AND CIGARETTES $ 12 TOTAL SALES TAX DUE — ADD LINES 9 THROUGH 11 $ 1,486 RoomsG SAL S TO GOVERNd MENT L,RELIGIOUS, n „itl AND -CHARITABLE ORGANIZATIONS $ 6,980 13 TOTAL USE TAX DUE — FROM USE TAX SCHEDULE BELOW $ H. RETURNED GOODS (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ 14 TOTAL TAX DUE AND PAYABLE - ADD LINES 12 AND 13 (MAKE CHECK PAYABLE TO THE CITY OF EVANS} $ 1,486 I. PRESCRIPTION DRUGS/PROSTHETIC DEVICES $ MY SIGNATURE I THE BEST OTHER SIGNATURE: DATE: PHONE: AFFIRMS THAT I HAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO OF MY KNOWLEDGE AND IS SIGNED SUBJECT TO PENALTIES FOR PERJURY AND CRIMINAL OFFENSES, J. FOOD PURCHASED WITH FOOD STAMPS/WIC VOUCHERS $ K. OTHER DEDUCTIONS ( PLEASE EXPLAIN) M1. S C Non- t axab 1 e ' $ 6 TITLE: Manager 3 TOTAL DEDUCTIONS (ADD LINES 3ATHRU 3K) $ 6,986 $ 43,912 (970) 356-21$O EMAIL: 4 TOTAL CITY NET TAXABLE SALES & SERVtCE {LINE 2B MINUS LINE 3} COMPUTATION OF USE TAX The City of Evans imposes a 3.5 % tax upon the privilege of using, staring, distributing or consuming in the City tangible property or taxable services purchased, rented or leased. Date of Purchase Name of Vendor Address Amount $ $ $ Subtotal $ Multiply Subtotal by 3.5% Total Use Tax Payable: $ _ CONSOLIDATED ACCOUNTS REPORT This schedule is required in all cases where the vendor is reporting sales for more than one location within the City of Evans. Each location must have a separate license. Account Number Business Location Address Total Gross Sales Total Deductions Net Taxable Sales $ $ $ $ $ $ Totals: $ $ $ CHANGES _ Mailing Address Address: New Email: New Owners (Requires a new license) Date: City, ST, Zip: New Business Phone: Name: Business Location Address New Address: Contact Phone: Phone: Business Closure or Sale (see instructions) Frequency: Call or email for change Date: City, ST, Zip: _ Filing Taxpayer game and Address CITY OF EVANS SALES AND USE TAX RETURN Mail To: Sales Tax Division Email: salestax@ci.evans.ca.us Dept. 2324 Phone: (970) 475-1109 Denver, CO 80291-2324 Fax; (970) 475-1194 rl� Lewis D Morales, LLC DBA Select Stay Hotel COLORADO 3025 8th Avenue Evans CO 80620 You MUST FILE THIS RETURN EVEN IF LINE 12 Is ZERO PERIOD COVERED DUE DATE ACCOUNT # February 2O18 03/20/18 O5O729 COMPUTATION OF SALES TAX 1 GROSS SALES AND SERVICES: (BEF0RESALESTAX) MUST BE REPORTED INCLUDING ALL SALES, RENTALS, LEASES, AND SERVICES, BOTH TAXABLE AND NON-TAXABLE $ 58,735 5 NET SALES TAX (LINE 4 X 3.5%} $ 1,750 2A ADD BAD DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED; $ 6 ADD EXCESS TAX COLLECTED 2B ADD LINES 1 & 2A $ 58,735 7 NET ADJUSTED SALES TAX (ADD LINES 5 & 6) $ 1,750 3 A. NON-TAXABLE SERVICES OR LABOR $ 8 DEDUCT 3.33% OF LINE 7 (ENTER 0 IF RETURN IS FILED LATE) ''MAXIMUM AMOUNT ALLOWED IS $100"" $ 58 B. SALES TO OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE $ 9 TOTAL SALES TAX DUE (LINE 7 MINUS LINE 8) $ 1 ,662 C. SALES SHIPPED OUT OF THE CITY OF EVANS $ 10 LATE FEES DUE IF FILED AFTER DUE DATE PENALTY: GREATER OF $15 OR 15% OF LINER $ PUT TOTAL BELOW D. BAD DEBTS CHARGED OFF (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ INTEREST: .75%0 PER MONTH OF LINE 9 - $ $ - -- E. TRADE-INS FOR TAXABLE RESALE $ 11 PRIOR PERIOD ADJUSTMENT FOR OVER OR UNDERPAYMENTS $ F. SALES OF GASOLINE AND CIGARETTES $ TOTAL SALES TAX DUE - ADD LINES 9 THROUGH 11 $ 1,662 yy G SAL S TO GOVERNMENTAL RELIGIOUS, ANDDHARITABLE ORGANIZATIONS $ 8,5580 TOTAL USE TAX DUE- FROM USE TAX SCHEDULE BELOW $ H. RETURNED GOODS (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ TOTAL TAX DUE AND PAYABLE - ADD LINES 12 AND 13 MAKE CHECK PAYABLE TO THE CITY OF EVANS) $ 1,662 I. PRESCRIPTION DRUGS/PROSTHET1C DEVICES $ MY SIGNATURE THE BEST OTHER SIGNATURE: DATE: PHONE: AFFIRMS THAT I HAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO OF MY KNOWLEDGE AND IS SIGNED SUBJECT TO PENALTIES FOR PERJURY AND CRIMINAL OFFENSES. . J. FOOD PURCHASED WITH FOOD STAMPS/WIC VOUCHERS $ K. OTHER DEDUCTIONS ( PLEASE EXPLAIN) M1 S C Nan- t axab 1 e $ 141 TITLE: Manager 3 TOTAL DEDUCTIONS (ADD LINES 3ATHRU 3i{) $ 8721 , (970) 356-2180 EMAIL: 4 TOTAL CITY NET TAXABLE SALES & SERVICE (LINE 28 MINUS LINE 3) $ 50,014 COMPUTATION OF USE TAX The City of Evans imposes a 3.5 % tax upon the privilege of using, storing, distributing or consuming in the City tangible property or taxable services purchased, rented or leased. Date of Purchase Name of Vendor Address Amount $ $ $ Subtotal $ Multiply Subtotal by 3.5% Total Use Tax Payable: $ CONSOLIDATED ACCOUNTS REPORT This schedule is required in all cases where the vendor is reporting sales for more than one location within the City of Evans. Each location must have a separate license. Account Number Business Location Address Total Gross Sales Tatai Deductions Net Taxable Sales $ $ $ — $ $ $ Totals; $ $ $ CHANGES Mailing Address Address: New New Email: New Owners (Requires a new license) Date: Business Phone: City, ST, Zip: Name: Business Location Address Address: New Filing Contact Phone: Phone: Frequency: Call or email for change Business Closure or Sale (see instructions) Date: City, ST, Zip: — Taxoaver Name and Address — CITY OF EVANS SALES AND USE TAX RETURN Mail To: Sales Tax Division Email: salestax@ci.evans.co.us Dept, 2324 Phone: (970) 475-1109 Denver, CO 8O291-2324 Fax: (970) 475-1194 d Lewis D Morales, LLC DBA Select Stay Hotel cflmoD 3025 8th Avenue Evans CO 80620 YOU MUST FILE THIS RETURN EVEN IF LINE 12 IS ZERO PERIOD COVERED DUE DATE ACCOUNT # March 2018 04/20/18 _ 050729 COMPUTATION OF SALES TAX GROSS SALES AND SERVICES: (BEFORE SALES TAX) MUST BE REPORTED INCLUDING ALL SALES, RENTALS, LEASES, AND SERVICES, BOTH TAXABLE AND NONTAXABLE $ 92,915 5 NET SALES TAX {LINE 4 x 3.5%) $ 2,985 2A ADD SAO DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED: $ 6 ADD EXCESS TAX COLLECTED $ 28 ADD LINES 1 & 2A $ 92,915 7 NET ADJUSTED SALES TAX (ADD LINES 5 & 6) $ 2,985 3 A. NON-TAXABLE SERVICES OR LABOR $ 8 DEDUCT 3.33% OF LINE 7 (ENTER 0 IF RETURN IS FILED LATE) ""MAXIMUM AMOUNT ALLOWED IS $100" $ 99 B. SALES TO OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE $ 9 TOTAL SALES TAX DUE (LINE 7 MINUS LINE 8) $ 2,886 - C. SALES SHIPPED OUT OF THE CITY OF EVANS $ 10 LATE FEES DUE ER IF FILED DUE DATE PENALTY: GREATER OF $15 OR 15°/a OF LINE 9 , $ PUT TOTAL BELOW D. BAD DEBTS CHARGED OFF (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ INTEREST: PER MONTH OF LINE 9 $ $ E. TRADE-INS FOR TAXABLE RESALE $ 11 PRIOR PERIOD ADJUSTMENT FOR OVER OR UNDERPAYMENTS $ F. SALES OF GASOLINE AND CIGARETTES $ 12 TOTAL SALES TAX DUE - ADD LINES 9 THROUGH 11 $ 2,886 �_ -,-- 5 WWII 30 G SALESITO GOVERNMENTAL RELIGIOUS, AND 'CHARITABLE ORGANIZATIONS - $ 7,528 13 TOTAL USE TAX DUE - FROM USE TAX SCHEDULE BELOW $ H. RETURNED GOODS (ON WHICH CITY TAX WAS PREVIOUSLY PAID) I $ 14 TOTAL TAX DUE AND PAYABLE - ADD LINES 12 AND 13 (MAKE CHECK PAYABLE TO THE CITY OF EVANS $ 2,886 I. PRESCRIPTION DRUGS/PROSTHETIC DEVICES $ MY SIGNATURE THE BEST OTHER SIGNATURE: DATE: PHONE: AFFIRMS THAT I HAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO OF MY KNOWLEDGE AND IS SIGNED SUBJECT TO PENALTIES FOR PERJURY AND CRIMINAL OFFENSES. -. ---- - J. FOOD PURCHASED WITH FOOD STAMPSIWIC VOUCHERS $ K. OTHER DEDUCTIONS (PLEASEEXPLAIN) Misc Non-taxable $ 108 TITLE: Mana ec, e 3 TOTAL DEDUCTIONS (ADD LINES 3A THRU 3K) $ 7,636 (97O) 356-2180 EMAIL: 4 TOTAL CITY NET TAXABLE SALES & SERVICE (LINE 28 MINUS LINE 3) $ 85,279 COMPUTATION OF USE TAX The City of Evans imposes a 3.5 % tax upon the privilege of using, storing, distributing or consuming in the City tangible property or taxable services purchased, rented or leased. Date of Purchase Name of Vendor Address Amount $ $ $ Subtotal $ Multiply Subtotal by 3.5% Total Use Tax Payable: $ CONSOLIDATED ACCOUNTS REPORT _ This schedule is required in all cases where the vendor is reporting sales for more than one location within the City of Evans, Each location must have a separate license. Account Number Business Location Address Total Gross Sales Total Deductions Net Taxable Sales $ $ $ — . $ $ $ Totals: $ $ $ _ CHANGES Mailing Address Address: New New Email: New Owners (Requires a new license) Date: Business Phone: City, ST, Zip: Name: Business Location Address Address: New Filing Contact Phone: Phone: Frequency: Call or email for change Business Closure or Sale (see instructions) Date: City, ST, Zip: Taxpayer Name and Addresssi CITY OF EVANS SALES AND USE TAX RETURN Mail To: Sales Tax Division Email: salestax@ci.evans.co.us Dept. 2324 Phone: (970) 475-1109 Denver, CO 8O291-2324 Fax: (970) 475-1194 Lewis D Morales, LLC DBA Select Stay Hotel COLORADO 3025 8th Avenue Evans CO 80620 You MUST FILE THIS RETURN EVEN IF LINE 12 IS ZERO PERIOD COVERED DUE DATE ACCOUNT # April 2018 O5/2O/18 050729 COMPUTATION OF SALES TAX GROSS SALES AND SERVICES: (BEFORE SALES TAX) MUST BE REPORTED INCLUDING ALL SALES, RENTALS, LEASES, AND SERVICES, BOTH TAXABLE AND NON-TAXABLE $ 91,024 5 NET SALES TAX {LINE 4 X 3,5%) $ 2,824 2A ADD BAD DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED: $ 6 ADD EXCESS TAX COLLECTED $ 28 ADD LINES 1 & 2A $ 91,024 7 NET ADJUSTED SALES TAX (ADD LINES 5 & 6) $ 2,824 3 A. NON-TAXABLE SERVICES OR LABOR $ B DEDUCT 3.33% OF LINE 7 (ENTER 0 IF RETURN IS FILED LATE) MAXIMUM AMOUNT ALLOWED IS $100 $ 94 B. SALES TO OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE $ 9 TOTAL SALES TAX DUE (LINE 7 MINUS LINE 8) $ 2,730 C. SALES SHIPPED OUT OF THE CITY OF EVANS $ 10 LATE FEES DUE IF FILED AFTER DUE DATE PENALTY; GREATER OF $15 0R 15% OF LINE 9 $ PUT TOTAL BELOW D. BAD DEBTS CHARGED OFF (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ INTEREST: .75% PER MONTH OF LINE 9 $ $ E. TRADE-INS FOR TAXABLE RESALE $ 11 PRIOR PERIOD ADJUSTMENT FOR OVER OR UNDERPAYMENTS $ F. SALES OF GASOLINE AND CIGARETTES $ 12 TOTAL SALES TAX DUE - ADD LINES 9 THROUGH 1I $ 2,730 Kearns rented for more inert ou us G. TO GOVERNMENTAL,y RELIGIOUS, AND CHARITABLE ORGANIZATIONS $ 10,235 13 TOTAL USE TAX DUE - FROM USE TAX SCHEDULE BELOW $ H. RETURNED GOODS (ON WHICH CITY TAx WAS PREVIOUSLY PAID) $ 14 TOTAL TAX DUE AND PAYABLE -ADD LINES 12 AND 13 (MAKE CHECK PAYABLE TO THE CITY OF EVANS) $ 2,730 I. PRESCRIPTION DRUGS/PROSTHETIC DEVICES $ MY SIGNATURE THE BEST OTHER SIGNATURE: DATE: PHONE: AFFIRMS THAT I HAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO OF MY KNOWLEDGE AND IS SHGNED SUBJECT TO PENALTIES FOR PERJURY AND CRIMINAL OFFENSES. J. FOOD PURCHASED WITH FOOD STAMPS/WIC VOUCHERS $ K. OTHER DEDUCTIONS ( PLEASE EXPLAIN) M1 s c Non-taxable $ 116 TITLE: Manager 3 TOTAL DEDUCTIONS (ADD LINES 3A THRU 3K) $ 107351 (970) 356-2180 EMAIL: 4 TOTAL CITY NET TAXABLE SALES & SERVICE (LINE 2B MINUS LINE 3) $ 673 COMPUTATION OF USE TAX The City of Evans imposes a 3.5 % tax upon the privilege of using, storing, distributing or consuming in the City tangible property or taxable services purchased, rented or leased. Date of Purchase J Name of Vendor I Address Amount $ $ $ Subtotal $ Multiply Subtotal by 3.5% Total Use Tax Payable: $ _ CONSOLIDATED ACCOUNTS REPORT This schedule is required in all cases where the vendor is reporting sales for more than one location within the City of Evans. Each location must have a separate license, Account Number Business Location Address Total Gross Sales Total Deductions Net Taxable Sales $ $ $ $ $ $ Totals: $ $ $ CHANGES Mailing Address Address: New New Email: New Owners (Requires a new license) Date: Business Phone: City, ST, Zip: Name: Business Location Address Address: New Filing Contact Phone: Phone: Frequency: Call or email for change Business Closure or Sale (see Instructions) Date: City, ST, Zip: Taxpayer Name and Address CITY OF EVANS SALES AND USE TAX RETURN Mail To: Sales Tax Division Email: salestax@ci,evans.co,us Dept. 2324 Phone: (970) 475-1109 Denver, CO 8O291-2324 Fax: (970) 475-1194 Lewis D Morales, LLC igi$V- DBA Select Stay Hotel coLOAAOD 3025 8th Avenue Evans CO 80620 YOU MUST FILE THIS RETURN EVEN IF LINE 12 IS ZERO PERIOD COVERED DUE DATE ACCOUNT # Ma 2018 06/20/18 050729 COMPUTATION OF SALES TAX 1 GROSS SALES AND SERVICES: (BEFORE SALES TAX) MUST 9E REPORTED INCLUDING ALL SALES, RENTALS, LEASES, AND SERVICES, BOTH TAXABLE AND NONTAXABLE I $ 95,890 5 NET SALES TAX (LINE 4 X 3.5%) $ 3,010 $ 2A ADD BAD DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED: $ 6 ADD EXCESS TAX COLLECTED 2B ADD LINES 1 & 2A $ 95,890 7 NET ADJUSTED SALES TAX (ADD LINES 5 & 6) $ 3,0 1 0 3 A. NON-TAXABLE SERVICES OR LABOR $ 8 DEDUCT 3.33% OF LINE 7 (ENTER 0 IF RETURN IS FILED LATE) *"MAXIMUM AMOUNT ALLOWED IS $1U0"" $ 1 00 B. SALES TO OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE $ 9 TOTAL SALES TAX DUE (LINE 7 MINUS LINE 8) $ 2,9 1 0 C. SALES SHIPPED OUT OF THE CITY OF EVANS $ 10 LATE FEES DUE IF FILED AFTER DUE DATE PENALTY: GREATER OF $150815% OF LINE 9 $ _ PUT TOTAL BELOW D. BAD DEBTS CHARGED OFF (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ INTEREST: .75% PER MONTH OF LINE 9 $ $ E. TRADE-INS FOR TAXABLE RESALE $ 11 PRIOR PERIOD ADJUSTMENT FOR OVER OR UNDERPAYMENTS $ F. SALES OF GASOLINE AND CIGARETTES $ 12 TOTAL SALES TAX DUE - ADD LINES 9 THROUGH 11 $ 2,910 G SALES TO GOVERNMENTAmore,ELIG then 30 ANDCHARITABLE ORGANIZATIONS $ 9,735 13 TOTAL USE TAX DUE - FROM USE TAX SCHEDULE BELOW $ H. RETURNED GOODS (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ 14 TOTAL TAX DUE AND PAYABLE - ADD LINES 12 AND 13 (MAKE CHECK PAYABLE TO THE CITY OF EVANS) $ 2,910 I, PRESCRIPTION DRUGS/PROSTHETIC DEVICES $ MY SIGNATURE THE BEST OTHER SIGNATURE: DATE: PHONE: AFFIRMS THAT I HAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO OF MY KNOWLEDGE AND IS SIGNED SUBJECT TO PENALTIES FOR PERJURY AND CRIMINAL OFFENSES. J. FOOD PURCHASED WITH FOOD STAMPS/WIC VOUCHERS $ K. OTHER DEDUCTIONS (PLEASEEXPLAIN) Misc Non-taxable $ 143 TITLE: Manager 3 TOTAL DEDUCTIONS (ADD LINES 3A THRU 3K) $ 9,878 (970) 356-2180 EMAIL: 4 TOTAL CITY NET TAXABLE SALES & SERVICE (LINE 2B MINUS LINE 3) $ 86,012 COMPUTATION OF USE TAX The City of Evans imposes a 3,5 % tax upon the privilege of using, storing, distributing or consuming in the City tangible property or taxable services purchased, rented or leased. Date of Purchase Name of Vendor Address Amount $ Subtotal $ Multi 1 Subtotal b 3.5% Total Use Tax Pa able: $ CONSOLIDATED ACCOUNTS REPORT This schedule is required in all cases where the vendor is reporting sales for more than one location within the City of Evans. Each location must have a separate license. Account Number Business Location Address Total Gross Sales Total Deductions Net Taxable Sales $ $ $ $ $ $ Totals: $ $ $ _ CHANGES _ Mailing Address Address: New New Email: New Owners (Requires a new license) Date: City, ST, Zip: Business Phone: Name: Business Location Address Address: New Filing Contact Phone: Phone: Business Closure or Sale (see instructions) Frequency: Call or email for change Date: City, ST, Zip: Taxpayer Name and Address CITY OF EVANS SALES AND USE TAX RETURN Mail To: Sales Tax Division Email: salestax@ci.evans.co,us Dept. 2324 Phone: (970) 475-1109 Denver, CO 80291-2324 Fax: (970) 475-1194 , Lewis D Morales, LLC DBA Select Stay Hotel eotoa;co- 3025 8th Avenue Evans CO 80620 YOU MUST FILE THIS RETURN EVEN IF LINE 1215 ZERO PERIOD COVERED DUE DATE ACCOUNT # June 2018 07/20/18 O5O729 COMPUTATION OF SALES TAX - - - GROSS SALES AND SERVICES: (BEFORE SALES TAX) MUST BE REPORTED INCLUDING ALL SALES, RENTALS, LEASES, AND SERVICES, BOTH TAXABLE AND NON-TAXABLE $ 92,175 5 NET SALES TAX (LINE 4 x 3.5%) $ 2,841 - 2A ADD BAD DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED: $ 6 ADD EXCESS TAX COLLECTED $ 28 ADD LINES 1 & 2A $ 92.175 7 NET ADJUSTED SALES TAX (ADD LINES 5 & 6) $ 2,84 1 3 A. NON-TAXABLE SERVICES OR LABOR $ 8 DEDUCT 3.33% .3OF LINE 7 (ENTER 0 IF RETURN IS FILED LATE) MAXIMUM AMOUNT ALLOWED IS $1 OO $ 95J ■ B. SALES TO OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE $ 9 TOTAL SALES TAX DUE (LINE 7 MINUS LINE 8) $ 2,746 C. SALES SHIPPED OUT OF THE CITY OF EVANS $ 10 LATE FEES DUE IF FILED AFTER DUE DATE PENALTY: GREATER OF $15 OR 15% OF LINE 9 $ PUT TOTAL BELOW D. BAD DEBTS CHARGED OFF (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ INTEREST: . .75% PER MONTH OF LINE 9 $ $ ___ E, TRADE-INS FOR TAXABLE RESALE $ 11 PRIOR PERIOD ADJUSTMENT FOR OVER OR UNDERPAYMENTS $ F. SALES OF GASOLINE AND CIGARETTES ' $ 12 TOTAL SALES TAX DUE - ADD LINES 9 THROUGH 11 8 2,746 `ooms ren e' or more en i I.a s G. SALES TO GOVERNMENTAL, RELIGIOUS, AND CHARITABLE ORGANIZATIONS $ 1 1,000 13 TOTAL USE TAX DUE - FROM USE TAX SCHEDULE BELOW $ H. RETURNED GOODS (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ 14 TOTAL TAX DUE AND PAYABLE - ADD LINES 12 AND 13 MAKE CHECK PAYABLE TO THE CITY OF EVANS $ 2,746 ■ I. PRESCRIPTION DRUGS/PROSTHETIC DEVICES - - $ MY SIGNATURE THE BEST OTHER SIGNATURE: DATE: PHONE: 1. AFFIRMS THAT I HAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO OF MY KNOWLEDGE AND IS SIGNED SUBJECT TO PENALTIES FOR PERJURY AND CRIMINAL OFFENSES. J. FOOD PURCHASED WITH FOOD STAMPS/WIC VOUCHERS $ ■ K. OTHER DEDUCTIONS ( PLEASE EXPLAIN) Mi S C Non- taxab 1 e $ 10 + - TITLE: Manager 3 TOTAL DEDUCTIONS (ADD LINES 3A THRU 3K) $ 1 1,0 1 0 (970) 356-2180 EMAIL: 4 TOTAL CITY NET TAXABLE SALES & SERVICE (LINE 2B MINUS LINE 3) $ 81 ,1655 - COMPUTATION OF USE TAX The City of Evans imposes a 3.5 % tax upon the privilege of using, storing, distributing or consuming in the City tangible property or taxable services purchased, rented or leased. Date of Purchase Name of Vendor Address Amount $ $ $ Subtotal $ Multiply Subtotal by 3.5% Total Use Tax Payable: $ CONSOLIDATED ACCOUNTS REPORT This schedule is required in all cases where the vendor is reporting sales for more than one location within the City of Evans. Each location must have a separate hearse. Account Number Business Location Address Total Gross Sales Total Deductions Net Taxable Sales $ $ $ $ $ $ Totals: $ $ $ CHANGES _ Mailing Address Address: New New Email: New Owners (Requires a new license) Date: Business Phone: City, ST, Zip: Name: Business Location Address Address: New Filing Contact Phone: Phone: Frequency: Call or email for change Business Closure or Sale (see instructions) Date: City, ST, Zip. Taxpayer Name and Addr s CITY OF EVANS SALES AND USE TAX RETURN Mail To: Sales Tax Division Email: salestax@ci.evans,co,us Dept. 2324 Phone: (970) 475-1109 Denver, CO 80291-2324 Fax: (970) 475-1194 tir or } Lewis D Morales, LLC / DBA Select Stay Hotel 6coLoaxua 3025 8th Avenue Evans CO 80620 You MUST FILE THIS RETURN EVEN IF LINE 12 IS ZERO PERIOD COVERED DUE DATE ACCOUNT # July 2018 08/20/18 050729 COMPUTATION OF SALES TAX 1 GROSS SALES AND SERVICES: (BEFORE SALES TAX) MUST BE REPORTED INCLUDING ALL SALES, RENTALS, LEASES, AND SERVICES, BOTH TAXABLE AND NONTAXABLE $ 103,567 5 NET SALES TAX (LINE 4 X 3.5%) $ 3,063 2A ADD BAD DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED: I $ 6 ADO EXCESS TAX COLLECTED $ 2B ADD LINES 1 & 2A I $ 103,567 7 NET ADJUSTED SALES TAX (ADD LINES 5 & 6) $ 3,063 3 A. NON-TAXABLE SERVICES OR LABOR $ 8 DEDUCT 3.33% OF LINE 7 (ENTER 0 IF RETURN IS FILED LATE} MAXIMUM AMOUNT ALLOWED IS $104 $ 1 02 B. SALES TO OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE $ 9 TOTAL SALES TAX DUE (LINE 7 MINUS LINE 8) t $ 2,961 C. SALES SHIPPED OUT OF THE CITY OF EVANS $ 10 LATE FEES DUE IF FILED AFTER DUE DATE PENALTY: GREATER OF , 815 OR 15% OF LINE 9 $ I PUT TOTAL BELOW D. BAD DEBTS CHARGED OFF (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ INTEREST; .75% PER MONTH OF LINE 9 $- $ E, TRADE-INS FOR TAXABLE RESALE - $ 11 PRIOR PERIOD ADJUSTMENT FOR OVER OR UNDERPAYMENTS $ 4 F. SALES OF GASOLINE AND CIGARETTES $ 12 TOTAL SALES TAX DUE - ADD LINES 9 THROUGH 11 $ 2,961 Rooms G SAES TOFGOVERNr ENTAtt, ented for more OUS, AAND'CHARITABLE ORGANIZATIONS $ 15,514 13 TOTAL USE TAX DUE - FROM USE TAX SCHEDULE BELOW $ H. RETURNED GOODS (ON WHICH CITY TAX WAS PREVIOUSLY PAID} $ 14 TOTAL TAX DUE AND PAYABLE - ADD LINES 12 AND 13 MAKE CHECK PAYABLE TO THE CITY OF EVANS $ 2, 961 I. PRESCRIPTION DRUGS/PROSTHETIC DEVICES $ MY SIGNATURE THE BEST OTHER SIGNATURE: DATE: PHONE: AFFIRMS THAT I HAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO OF MY KNOWLEDGE AND IS SIGNED SUBJECT TO PENALTIES FOR PERJURY AND CRIMINAL OFFENSES. J. FOOD PURCHASED WITH FOOD STAMP5/NIC VOUCHERS $ K. OTHER DEDUCTIONS ( PLEASE EXPLAIN) Misc Non-taxable $ 525 TITLE: Manager 3 TOTAL DEDUCTIONS (ADD LINES 3A THRU 3K) 5 16,039 (970) 356-2180 EMAIL: 4 TOTAL CITY NET TAXABLE SALES & SERVICE (LINE 2a MINUS LINE 3) $ 87,528 COMPUTATION OF USE TAX The City of Evans imposes a 3.5 % tax upon the privilege of using. storing, distributing or consuming in the City tangible property or taxable services purchased, rented or leased. Date of Purchase Name of Vendor Address Amount $ $ $ Subtotal $ _ Multiply Subtotal by 3.5% Total Use Tax Payable: $ _ _ _ __ _ CONSOLIDATED ACCOUNTS REPORT This schedule is required in all cases where the vendor is reporting sales for more than one location within the City of Evans. Each location must have a separate license, Account Number Business Location Address Total Gross Sales Total Deductions Net Taxable Sales $_ $ $ $ $ $ Totals: $ _ $ _ __ $ CHANGES — Mailing Address Address: New Email: New Owners (Requires a new license) Date: City, ST, Zip: New Business Phone: Name: Business Location Address New Address: Contact Phone: Phone: Business Closure or Sale (sea instructions) Frequency: Call or email for change Date: City, ST, Zip: Filing Taxpayer Name and Address CITY OF EVANS SALES AND USE TAX RETURN Mail To: Sales Tax Division Email: salestax@ci.evans.co,us Dept. 2324 Phone: (970) 475-1109 Denver, CO 60291-2324 Fax: (970) 475-1194 - Lewis D Morales, LLC &„va.,ritsvDBA Select Stay Hotel ceLormea 3025 8th Avenue Evans Co 80620 YOU MUST FILE THIS RETURN EVEN IF LINE 12 is ZERO PERIOD COVERED DUE DATE ACCOUNT f August 2018 O9/2O/18 O5O729 i COMPUTATION OF SALES TAX 1 GROSS SALES AND SERVICES: (BEFORE SALES TAX) MUST BE REPORTED INCLUDING ALL SALES RENTALS, LEASES, AND SERVICES, BOTH TAXABLE AND NON-TAXABLE $ 105,232© NET SALES TAX (LINE 4 X3.6%) $ 3,108 $ ADD BAD DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED:1W1I]IIa',f.1IV!E!1HKt:11 2B ADD LINES 1 & 2A $ 105,232 7 NET ADJUSTED° $ 3,108 $ 1O3 3 A. NON-TAXABLE SERVICES DR LABOR $ 8 QEOUCT 3.33% OF LINE 7 (ENTER 0 IF RETURN **MAXIMUM AMOUNT ALLOWED IS $100*" IS FILED LATE} $ 3,0 O 5 PUT TOTAL BELOW B. SALES TO OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE $ 9 TOTAL SALES TAX DUE (L1NE 7 MINUS LINES) C. SALES SHIPPED OUT OF THE CITY OF EVANS — $ LATE FEES DUE PENALTY: n REATER OF $15 OR 15 /a OH LINE 9 $ $ $ 10 IF FILED AFTER DUE GATE INTEREST:.75% PER MONTH DF LINE S $ D. BAD DEBTS CHARGED OFF {ON WHICH CITY TAX WAS PREVIOUSLY PAID) II, E. TRAOE-INS FOR TAXABLE RESALE $ 11 _ PRIOR PERIDD ADJUSTMENT FOR OVER OR UNDERPAYMENTS $ 12 TOTAL SALESTAxDUE-ADDLINES9THROUGHII F. SALES OF GASOLINE AND CIGARETTES $ 16,413 13 TOTAL USE TAX DUE- FROM USE TAX SCHEDULE BELOW $ $ 3,005 ■ ayS G. SALES TO corns ren e.°r more en AND ° ° H. RETURNED GOODS PAID)14 TOTAL TAX DUE AND PAYABLE- ADD LINES 12AND13 (MAKE CHECK PAYABLE TO THE CITY OF EVANS) I. PRESCRIPTION DRUGS/PROSTHETIC DEVICES MY SIGNATURE AFFIRMS THAT I HAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND IS SIGNED SUDJECT TO PENALTIES FOR PERJURY AND J. FOOD PURCHASED WITH F000 STAMPSIWIC VOUCHERS $ OTHER CRIMINAL OFFENSES. K. OTHER DEDUCTIONS ( PLEASE EXPLAIN) Mi S C Non- t. axab 1 e $ 1O SIGNATURE: 3 TOTAL DEDUCTIONS {ADO LINES 3ATHRU 3K) $ 16,423 DATE: TITLE: Manager 4 TOTAL CITY NET TAXABLE SALES & SERVICE (LINE 2B MINUS LINE 3) $ 88, 8O9 PHONE: (970) 356-2180 EMAIL: COMPUTATION OF USE TAX The City cf Evans imposes a 3.5 % tax upon the privilege of using, storing, distributing or consuming in the City tangible property or taxable services purchased, rented or leased. Date of Purchase Name of Vendor Address Amount $ $ $ Subtotal $ Multiply Subtotal by 3.5% Total Use Tax Payable: $ CONSOLIDATED ACCOUNTS REPORT This schedule is required in all cases where the vendor is reporting sales for more than one location within the City of Evans. Each location must have a separate license. Account Number Business Location Address Total Gross Sales Total Deductions Net Taxable Sales $ $ $ $ $ $ Totals: $ $ $ CHANGES Mailing Address Address: New New Email: New Owners (Requires a new license) Date: Business Phone: City, ST, Zip: Name: Business Location Address Address: New Filing Contact Phone: Phone: Frequency: Call or email for change Business Closure or Sale (see instructions) Date: City, ST, Zip: Taxpayer Name and Address I CITY OF EVANS SALES AND USE TAX RETURN Mail To: Sales Tax Division Email: salestax@ci.evans.co,us Dept. 2324 Phone: (97O) 475-1109 Denver, CO 80291-2324 Fax: (97O) 475-1194 bLewis D Morales, LLC DBA Select Stay Hotel L�� 0 3025 8th Avenue Evans CO 80620 YOU MUST FILE THIS RETURN EVEN IF LINE f2ISZERO PERIOD COVERED DUE DATE ACCOUNT # September 2018 1O/22/18 O5O729 COMPUTATION OF SALES TAX 1 GROSS SALES AND SERVICES: (BEFORE SALES TAX) MUST BE REPORTED INCLUDING ALL SALES, RENTALS, LEASES, AND SERVICES, BOTH TAXABLE AND NON-TAXABLE $ 1 02, 576 5 NET SALES TAX (LINE 4 x 3.5%) $ 2,745 2A ADD BAD DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED, $ 6 ADO EXCESS TAX COLLECTED $ 28 ADD LINES 1 & 2A $ 102,576 7 NET ADJUSTED SALES TAX {ADD LINES 5 & 6) $ 2,745 $ 91 3 A. NON-TAXABLE SERVICES OR LABOR $ 8 DEDUCT 3.33% OF LINE 7 (ENTER 0 IF RETURN ISFILED LATE) **MAXIMUM AMOUNT ALLOWED IS $100* B. SALES TO OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE $ 9 TOTAL SALES TAX DUE (LINE 7 MINUS LINE 8) $ 2,654 C. SALES SHIPPED OUT OF THE CITY OF EVANS $ 10 LATE FEES DUE IF FILED AFTER DUE DATE PENALTY: GREATER OF $15 OR 15% OF LINE 9 $ -_ PUT TOTAL BELOW - - - D. BAD DEBTS CHARGED OFF (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ INTEREST: .75% PER MONTH OF LINE 9 $ $ E. TRADE-INS FOR TAXABLE RESALE $ 11 PRIOR PERIOD ADJUSTMENT FOR OVER OR UNDERPAYMENTS $ F, SALES OF GASOLINE AND CIGARETTES $ 12 TOTAL SALES TAX DUE - ADD LINES 9 THROUGH 11 $ 2,654 Rooms rented for more then 30 days G, SALES TO GOVE RNMENTAL, RELIGIOUS. ANOOHARITABLE ORGANIZATIONS $ 23,955 13 TOTAL USE TAX DUE - FROM USE TAX SCHEDULE BELOW $ H. RETURNED GOODS (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ 14 TOTAL TAX DUE AND PAYABLE -ADD LINES 12 AND 13 MAKE CHECK PAYABLE TO THE CITY OF EVANS) $ 2,654 I, PRESCRIPTION DRUGS/PROSTHETIC DEVICES $ MY SIGNATURE THE BEST OTHER SIGNATURE: DATE: PHONE: AFFIRMS THAT I HAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO OF MY KNOWLEDGE AND IS SIGNED SUBJECT TO PENALTIES FOR PERJURY AND CRIMINAL OFFENSES. J. FOOD PURCHASED WITH FOOD STAMPS/WIC VOUCHERS $ K. OTHER DEDUCTIONS (PLEASEEXPLAIN) Misc Non-taxable $ 182 TITLE: Manager 3 TOTAL DEDUCTIONS {ADD LINES 3A THRU 3K) $ 24,137 (970) 356-2130 EMAIL'. 4 TOTAL CITY NET TAXABLE SALES & SERVICE {LINE 28 MINUS LINE 3) $ 78,439 COMPUTATION OF USE TAX The City of Evans imposes a 3.5% tax upon the privilege of using, storing, distributing or consuming in the City tangible properly or taxable services purchased, renlea or leased. Date of Purchase Name of Vendor Address Amount $ Subtotal $ Multiply Subtotal by 3.5% Total Use Tax Payable: $ CONSOLIDATED ACCOUNTS REPORT This schedule is required in all cases where the vendor is reporting sales for more than one location within the City of Evans. Each location must have a separate license. Account Number Business Location Address Total Gross Sales Total Deductions Net Taxable Saps $ $ $ $ $ $ Totals: $ $ $ --- ..— -- - - — - - CHANGES — . - ---- Mailing Address Address: _ New New Email: New Owners (Requires a new license) Date: Business Phone: City, ST, Zip: Name: Business Location Address Address: New Filing Contact Phone: Phone: Frequency: Call or email for change Business Closure or Sale (bee lnelructionel Date: City, ST, Zip: Taxpayer Name and Address CITY OF EVANS SALES AND USE TAX RETURN Mail To: Sales Tax Division Email: salestax@ci.evans.co.us Dept. 2324 Phone: (970) 475-1109 Denver, CO 80291-2324 Fax: (970) 475-1194 sd. Lewis D Morales, LLC DBA Select Stay Hotel MAMBO 3025 8th Avenue Evans CO 80620 YOU MUST FILE THIS RETURN EVEN IF LINE 12 IS ZERO PERIOD COVERED DUE DATE ACCOUNT # October 2O18 1 1/20/1 8 050729 COMPUTATION OF SALES TAX 1 GROSS SALES AND SERVICES: (BEFORE SALES TAX} MUST BE REPORTED INCLUDING ALL SALES, RENTALS, LEASES, AND SERVICES, BOTH TAXABLE AND NON-TAXABLE $ 104 447 5 NET SALES TAX {LINE 4 x 3.5%) $ 2, 355 2A ADD BAD DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED: $ 6 ADD EXCESS TAX COLLECTED $ ADD LINES 1 & 2A $ 104 447 , 7 NET ADJUSTED SALES TAX {ADD LINES 5 & 6) DEDUCT 3.33% OF LINE 7 (ENTER Q IF RETURN !S FILED LATE) "tMAXIMUM AMOUNT ALLOWED IS $iO0" $ 78 A. NON-TAXABLE SERVICES OR LABOR -, $ TOTAL SALES TAX DUE (LINE 7 MINUS LINE B) $ 2,277 B. SALES TO OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE $ " LATE FEES DUE PENALTY: GREATER OF $15 OR 15% OF LINE 9 $ PUT TOTAL BELOW ■ C. SALES SHIPPED OUT OF THE CITY OF EVANS $ r IF FILED AFTER DUE DATE INTEREST; .75% PER MONTH OF LINES $ $ _ _ _ --- -- D. BAD DEBTS CHARGED OFF (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ E. TRADE-INS FOR TAXABLE RESALE $ 11PRIOR PERIOD ADJUSTMENT FOR OVER OR UNDERPAYMENTS $ 12 TOTAL' ' LINES 9 THROUGH$ 2,277 F. SALES OF GASOLINE AND CIGARETTES $ Rooms rented tor more than 3O days G. SALES TO GOVERNMENTAL, RELIGIOUS, AND CHARITABLE ORGANIZATIONS $ 37,165 13 TOTAL USE TAX DUE- FROM USE TAX SCHEDULE BELOW $ 14 TOTAL TAX DUE AND PAYABLE -ADD LINES 72 AND 13 MAKE CHECK PAYABLE TO THE CITY OF EVANS $ 2,277 H. RETURNED GOODS {ON WHICH CITY TAX WAS PREVIOUSLY PAID) I. PRESCRIPTION DRUGS/PROSTHETIC DEVICES MY THE OTHER SIGNATURE AFFIRMS THAT I HAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO BEST OF MY KNOWLEDGE AND IS SIGNED SUBJECT TO PENALTIES FOR PERJURY AND CRIMINAL OFFENSES. J. FOOD PURCHASED WITH FOOD STAMPS/WIC VOUCHERS K. OTHER DEDUCTIONS ( PLEASE EXPLAIN) M i S c Non-taxable $ 0 SIGNATURE: DATE: TITLE: Manager TOTAL DEDUCTIONS (ADD LINES 3A THRU 38) $ 37,165 PHONE: (970) 356-2180 EMAIL: ' $ 67,282 4 TOTAL CITY NET TAXABLE SALES & SERVICE (LINE 2B MINUS LINE 3) COMPUTATION OF USE TAX The City of Evans imposes a 3.5 % tax upon the privilege of using, staring, distributing or consuming in the City tangible property or taxable services purchased, rented or leased. Date of Purchase Name of Vendor Address Amount $ $ $ Subtotal $ Multi • I Subtotal b 3.5% Total Use Tax Pa able: $ CONSOLIDATED ACCOUNTS REPORT This schedule is required in all cases where the vendor is reporting sales for more than one location within the City of Evans. Each location must have a separate license. Account Number Business Location Address Total Gross Sales Total Deductions Net Taxable Sales $ $ $ $ $ $ Totals: $ $ $ _ CHANGES Mailing Address Address: New New Email: New Owners (Requires a new license) Date: Business Phone: City, ST, Zip: Name: Business Location Address Address: New Filing Contact Phone: Phone: Frequency: Call or email for change Business Closure or Sale (lee Instructions) Date: City, ST, Zip: Taxpayer Name an¢ Address — —' CITY OF EVANS SALES AND USE TAX RETURN Mail To: Sales Tax Division Email: salestax@ci.evans.co.us Dept. 2324 Phone: (970) 475-1109 Denver, CO 80291-2324 Fax: (970) 475-1194 svolv,ir Lewis D Morales, LLC DBA Select Stay Hotel CA3025 8th Avenue Evans Co 80620 YOU MUST FILE THIS RETURN EVEN IF LINE 12 IS ZERO I PERIOD COVERED DUE DATE ACCOUNT # November 2O18 12/20/18 O5O729 COMPUTATION OF SALES TAX GROSS SALES AND SERVICES: {BEFORE SALES TAX) MUST BE REPORTED INCLUDING ALL SALES, RENTALS, LEASES, AND SERVICES, BOTH TAXABLE AND NON-TAXABLE $ 94,406 5 NET SALES TAX (LINE 4 x 3.5%) $ 1,931 2A ADD BAD DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED: $ 6 ADD EXCESS TAX COLLECTED $ 2B ADD LINES 1 & 2A $ 94,406. 7 NET ADJUSTED SALES TAX (ADD LINES 5 & 6) $ 1,931 3 A. NON-TAXABLE SERVICES OR LABOR 8 DEDUCT 3.33% OF LINE 7 (ENTER 0 IF RETURN IS FILED LATE) "MAXIMUM AMOUNT ALLOWED IS $100*" $ 64 B. SALES TO OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE 9 TOTAL SALES TAX DUE (LINE 7 MINUS LINE 8) $ 1 , 867 C. SALES SHIPPED OUT OF THE CITY OF EVANS LATE FEES DUE PENALTY: GREATER OF $15 oR 15% OF LINE 9 $ PUT TOTAL BELOW 1 D. BAD DEBTS CHARGED OFF (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ 10 IF FILED AFTER DUE DATE INTEREST: .75% PER MONTH OF LINE 9 $ E. TRADE-INS FOR TAXABLE RESALE $ 11 PRIOR PERIOD ADJUSTMENT FOR OVER OR UNDERPAYMENTS $ F. SALES OF GASOLINE AND CIGARETTES $ 12 TOTAL SALES TAX DUE - ADD LINES 9 THROUGH 11 $ 1,867 G SA ES TO GOVERMMa4 ADL,, RELIGIO S, NDtHARITABLE ORGANIZATIONS $ 39,221 13 TOTAL USE TAX DUE - FROM USE TAX SCHEDULE BELOW $ H. RETURNED GOODS ION WHICH CITY TAX WAS PREVIOUSLY PAID) $ 14 TOTAL TAX DUE AND PAYABLE -ADD LINES 12 AND 13 (MAKE CHECK PAYABLE TO THE CRY OF EVANS) $ 1,867 ■ I. PRESCRIPTION DRUGS/PROSTHETIC DEVICES $ MY SIGNATURE THE BEST OTHER SIGNATURE: DATE: PHONE: AFFIRMS THAT I HAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO OF MY KNOWLEDGE AND IS SIGNED SUBJECT TO PENALTIES FOR PERJURY AND CRIMINAL OFFENSES. ■ J. FOOD PURCHASED WITH FOOD STAMPSIWIC VOUCHERS $ K. OTHER DEDUCTIONS ( PLEASE EXPLAIN) M1 s c Nan - taxable $ 0 TITLE: Manager 3 TOTAL DEDUCTIONS (ADD LINES 3A THRU 3K) $ 39,221 (970) 356-2180 EMAIL: 4 TOTAL CITY NET TAXABLE SALES & SERVICE (LINE 2B MINUS LINE 3) $ 55,185 COMPUTATION OF USE TAX The City of Evans imposes a 3.5 % tax upon the privilege of using, storing, distributing or consuming in the City tangible property or taxable services purchased, rented or leased. Date of Purchase Name of Vendor Address Amount $ $ $ Subtotal $ Multiply Subtotal by 3.5°/0_ Total Use Tax Payable: $ CONSOLIDATED ACCOUNTS REPORT - This schedule is required in all cases where the vendor is reporting sales for more than one location within the City of Evans. Each location must have a separate license, Account Number Business Location Address Total Gross Sales Total Deductions Net Taxable Sales $ $ $ $ $ $ Totals: $ $ $ CHANGES Mailing Address Address: New New Email: New Owners (Requires a new license) Date: Business Phone: City, ST, Zip: Name: — _ Business Location Address Address: New Filing Contact Phone: Phone: Frequency: Call or email for change Business Closure or Sale (see instructions) Date: City, ST, Zip: Taxoaver Name and Address CITY OF EVANS SALES AND USE TAX RETURN Mail To: Sales Tax Division Email: salestax@ci.evans.co,us Dept, 2324 Phone: (970) 475-1109 Denver, CO 80291-2324 Fax: (970) 475-1194 C 0 Lewis D Morales, LLC DBA Select Stay Hotel co -Low° 3025 8th Avenue Evans CO 8O62O You MUST FILE THIS RETURN EVEN IF LINE 12 IS ZERO PERIOD COVERED DUE DATE ACCOUNT # December 2018 1/22/19 050729 COMPUTATION OF SALES TAX GROSS SALES AND SERVICES: (BEFORE SALES TAX) MUST BE REPORTED INCLUDING ALL SALES, RENTALS, LEASES, AND SERVICES, BOTH TAXABLE AND NONTAXABLE $ 77,103 5 NET SALES TAX (LINE 4 X 3.5%) $ 1,66 9 ADD BAD DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED: $ $ ADD EXCESS TAX COLLECTED $ 2B ADD LINES 1 & 2A $ 77,103 7 NET ADJUSTED SALES TAX (ADD LINES 5 & 6) $ 1,669 3 A. NON TAXABLE SERVICES OR LABOR $ 8 DEDUCT 3.33% OF LINE 7 (ENTER 0 IF RETURN IS FILED LATE) ""MAXIMUM AMOUNT ALLOWED iS $100"'` $ 56 8. SALES IC OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE $ 9 TOTAL SALES TAX DUE (LINE 7 MINUS LINE 8) I $ 1,613 C. SALES SHIPPED CUT OF THE CITY OF EVANS $ 10 LATE FEES DUE IF FILED AFTER DUE DATE PENALTY: GREATER OF $15 0R 15% OF LINES $ _ PUT TOTAL BELOW D. BAD DEBTS CHARGED OFF (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ INTEREST: .75% PER MONTH OF LINE 9 $ $ E. TRACE -INS FOR TAXABLE RESALE $ 11 PRIOR PERIOD ADJUSTMENT FOR OVER OR UNDERPAYMENTS $ F. SALES OF GASOLINE AND CIGARETTES $ 12 TOTAL SALES TAX DUE - ADD LINES 9 THROUGH 11 $ 1,613 yy Kooms G SALES TO GOVERNH NTr ALR eLIGIO S,ANDcHARTABLEORGANIZATIONS $ 29,427 13 TOTAL USE TAX DUE - FROM USE TAX SCHEDULE BELOW $ H. RETURNED GOODS (ON WHICH CITY TAX WAS PREVIOUSLY PAID) $ 14 TOTAL TAX DUE AND PAYABLE -ADD LINES 12 AND 13 (MAKE CHECK PAYABLE TO THE CITY OF EVANS) $ 1,613 I. PRESCRIPTION DRUGS/PROSTHETIC DEVICES $ MY SIGNATURE THE BEST OTHER SIGNATURE: DATE: PHONE: AFFIRMS THAT I HAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO OF MY KNOWLEDGE AND IS SIGNED SUBJECT TO PENALTIES FOR PERJURY AND CRIMINAL OFFENSES. - - — -- — -- + J. FOOD PURCHASED WITH FOOD STAMPS/WIC VOUCHERS $ K. OTHER DEDUCTIONS (PLEASEEXPLAIN) Misc Non-taxable $ 0 TITLE: Manager TOTAL DEDUCTIONS (ADO LINES 3ATHRU 3K) $ 29 427 (970) 356-2180 EMAIL: TOTAL CITY NET TAXABLE SALES & SERVICE (LINE 29 MINUS LINE 3} $ 47,676 COMPUTATION OF USE TAX The City of Evans imposes a 3,5 % tax upon the privilege of using, storing, distributing or consuming in the City tangible property or taxable services purchased, rented or leased. Date of Purchase Name of Vendor Address Amount $ $ $ Subtotal $ Multiply Subtotal by 3.5% Total Use Tax Payable: $ CONSOLIDATED ACCOUNTS REPORT This schedule is required in all cases where the vendor is reporting sales for more than one location within the City of Evans. Each location must have a separate license. Account Number Business Location Address Total Gross Sales Total Deductions Net Taxable Sales $ $ $ $ $ $ Totals: $ $ $ --- — — . CHANGES Mailing Address Address: New New Email: New Owners (Requires a new license) Date: Business Phone: City, ST, Zip: Name: Business Location Address Address: New Filing Contact Phone: Phone: Frequency: Call or email for change Business Closure or Sale (see instructions) Date: City, ST, Zip: Property Tax Advisors, Inc. 3090 S. Jamaica Ct., Suite 204 Aurora, Colorado 80014 (303)368-0500 FAX (303)368-0573 Email; propertytax@cotaxes.net CONSULTANT AGENCY AGREEMENT Property Owner: Morales Lewis D., LLC County: Weld PIN. Property Address R7130298 3025 8th Avenue na Corporation ❑ a Partnership as Individuals a Trust FILL, The undersigned hereby appoints and authorizes Property Tax Advisors, Inc. as its Agent and Consultant in the preparation and execution of a real estate valuation appeal(s) on behalf of the undersigned in regard to the above enumerated property(ies) for the 2019 tax cycle and for the prior two years. The undersigned further authorizes Property Tax Advisors, Inc., as Agent of the undersigned, to execute and cause to be filed on behalf of the undersigned, in the name of the undersigned, any and all documents relating to an appeal of the subject property's(ies') valuation(s). This agreement is executed this day of {, Z///7 B'e Print Name: Telephone No.: 7/V 7 i' �� v10/1 Fax No.: 2-V - / Please check the appropriated line Er Property is Owner Occupied nProperty is Leased to Tenants ,207q. Title: (:-( -et (7 2 (If Corporation, your title; (or) Owner, General Partner, Lessee, Power of Attorney, Trustee, etc.) If property is partially owner occupied and partially leased please check both lines. Rev. 1/18 0 i/ VI § 041, lisiir % O( 1 k c6272-.014,9) o� < et 1520 00❑2 0981 6393 rR trj. ca ULF cie 44491 CP 1.68 ;tM '11 2 m : met } .44 r14-41 a.e ] j,.; p}$ tme 4 � § 0 N w ti - aid ex Lie 2 _ ale =I Clg Coo k k lw, INC Lki Cle j co U / co a) \ 2 / Hello