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Home My WebLink About20181955.tiffRESOLUTION RE: APPROVE, IN -PART, PETITION FOR ABATEMENT OR REFUND OF TAXES FOR ACCOUNT NUMBER R7130298 - MORALES, LEWIS D., LLC WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board of County Commissioners of Weld County, State of Colorado, at a duly and lawfully called regular meeting held on the 20th day of June, 2018, at which meeting there were present the following members: Chair Steve Moreno, and Commissioners Barbara Kirkmeyer, Sean P. Conway, Julie A. Cozad, and Mike Freeman, and WHEREAS, notice of such meeting and an opportunity to be present has been given to the taxpayer and the Assessor of said County, with said Assessor, Christopher Woodruff, being present, and taxpayer, Morales, Lewis D., LLC, being represented by, Property Tax Advisors, Inc., not being present, and WHEREAS, the Board of County Commissioners has carefully considered the attached petition, and is fully advised in relation thereto. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Board concurs with the recommendation of the Assessor and the petition be, and hereby is, approved, in -part, and an abatement or refund be allowed as follows: CORRECTION TO ASSESSED VALUATION ABATEMENT OR REFUND TAX YEAR $731,690.00 $13,911.37 2017 cc:ASR(CC.J/EZIOK), CO C U.PPL IA.PPL REP / 18- 2018-1955 AS0099 TAX ABATEMENT PETITION - MORALES, LEWIS D., LLC PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 20th day of June, A.D., 2018. ATTEST: detavo jek)oi Weld County Clerk to the Board BYO Deputy Clerk to the Board AP Date of signature: OColcl t BOARD OF COUNTY COMMISSIONERS WELDDFOUNTY, COLORADO lezn Steve Moreno, Chair/ `Barbara Kirkmeyer Pro-Tem A. Cozad ike Freeman C - 2018-1955 AS0099 al PETITION FOR ABATEMENT OR REFUND OF TAINCEIVED County: Weld Section I: Petitioner, please complete Section I only. Date: 3/1/18 Month Day Year Petitioner's Name: Morales, Lewis O. LLC Petitioner's Mailing Address: 3025 8th Ave. Evans City or To•r.in Co State Date Received (Use Assessor's or Cornmis��+p�i' 1te4ta LL X18 WELD COUNTY ASSESSOR GREELEY, COLORADO RECEIVED MAY 1 1 2018 WELD COUNTY COMMISSIONERS 80620 Zip Code SCHEDULE OR PARCEL NUMBER(S) PROPERTY ADDRESS OR LEGAL DESCRIPTION OF PROPERTY R7130298 3025 8th Ave. Petitioner requests an abatement or refund of the appropriate taxes and states that the taxes assessed against the - above property for the property tax year 2017 are incorrect for the following reasons: (Briefly describe why the taxes have been levied erroneously or illegally, whether due to erroneous valuation, irregularity in levying, j n\ clerical error, or overvaluation. Attach additional sheets if necessary.) / 1 Property is overvalued. Please see attached "Appeal of Real Property Valuation". Petitioner's estimate of value: $ 3,000,000.00 Value ( 2017 ) Year Sk.a3PM•31 i declare, under penalty of perjury in the second degree, that this petition, together with any accompanying exhibits or statements, has been prepared or examined by me, and to the best of my knowledge, information, and belief, is true, correct, and compete. Petitioner's Signature Daytime Phone Number ( ) Email By 1-1 Daytime Phone Number L 303 } 368.0500 Agent's Signature' Printed Name: Dariush Bozorgpour Property -fax Advisors, Inc. Email ptadvisor@propertytaxadvisor.net 'Letter of agency must be attached when petition is submitted by an agent lithe Board of County Commissioners, pursuant to § 39-10-114(1), C R.S., or the Property Tax Administrator. pursuant to § 39-2-116, C.R.S denies the petition far refund or abatement of taxes in whole or in part, the Petitioner may appeal to the Board of Assessment Appeals pursuant to the provisions of § 39-2-125, C.R.S., v,ithin thirty days of the entry of any such decision, § 39-10-114.5(1). C.R.S. Section II: Assessor's Recommendation (For Assessor's Use Only) Tax Year ori71.) ( ~' Original Corrected AbatelRefund Actual Awing 51DCOM-DO snLk‘500 coi5sa 2-3 3p9J400o rl?) 1$o UtD1tJ1O(0 0 - - �.� i 'to - ‘,1(\11:37 11 Assessor recommends approval as outlined above. If the request for abatement is based upon the grounds of overvaluation. no abatement or refund of taxes shall be made if an ob;ection or protest to such valuation has been filed and a Notice of Determination has been mailed to the taxpayer, § 39-10-1 14(1)(a)(I)(D), C.R.S. Tax year. Protest? D No O Yes (11 a protest was filed, please attach a copy of the NOD.) ❑ Assessor recommends denial for the following reason(s): 15-DPT-AR No. 920-66/17 Assessor's or Deputy Assessor's Sign ¢h :E ua c-in18IOt 2018-1955 FOR ASSESSORS AND COUNTY COMMISSIONERS USE ONLY (Section III or Section IV must be completed) Every petition for abatement or refund filed pursuant to § 39-10-114, C.R.S. shall be acted upon pursuant to the provisions of this section by the Board of County Commissioners or the Assessor, as appropriate, within six months of the date of filing such petition, § 39-1-113(1.7), C.R.S. L'.7irt Section III: Written Mutual Agreement of Assessor and Petitioner (Only for abatements up to S10,000) The Commissioners of County authorize the Assessor by Resolution No. to review petitions for abatement or refund and to settle by written mutual agreement any such petition for abatement or refund in an amount of $10,000 or less per tract, parcel, or lot of land or per schedule of personal property, in accordance with § 39-1-113(1.5), C.R.S. The Assessor and Petitioner mutually agree to the values and tax abatement/refund of: Tax Year Actual Original Corrected Abate/Refund Assessed JA8 Note* The total tax amount does not include accrued interest penalties, and fees associated veilh late and/or delinquent tax payments, if applicable. Please contad the County Treasurer for fun payment information. Petitioner's Signature Date Assessor's or Deputy Assessor's Signature Date 111171=1Er -_ Section IV: Decision of the County Commissioners (Must be completed if Section HI does not apply) WHEREAS, the County Commissioners of County, State of Colorado, at a duly and lawfully called regular meeting held on / I , at which meeting there were present the following members: Month Day Year with notice of such meeting and an opportunity to be present having been given to the Petitioner and the Assessor of said County and Assessor (being present --not present) and Name Petitioner (being present --not present), and WHEREAS, the said Name County Commissioners have carefully considered the within petition, and are fully advised in relation thereto, NOW BE IT RESOLVED that the Board (agrees --does not agree) with the recommendation of the Assessor, and that the petition be (approved --approved in part --denied) with an abatement/refund as follows: Year Assessed Value Taxes Abate/Refund Chairperson of the Board of County Commissioners' Signature t, County Clerk and Ex -Officio Clerk of the Board of County Commissioners in and for the aforementioned county, do hereby certify that the above and foregoing order is truly copied from the record of the proceedings of the Board of County Commissioners. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said County this _ day of Month Year County Clerk's or Deputy County Clerk's Signature Note: Abatements greater than 510,000 per schedule, per year, must be submitted in duplicate to the Property Tax Administrator for review. Section V: Action of the Property Tax Administrator (For all abatements greater than $10,000) The ion of the Board of County Co yi r*Iiire to this petition, is hereby + � Denied f• the followi : + reason(s): ❑ Approved in part $ 15-DPT-AR No, 920-66/17 02/09/2018 15:44 9703561910 02/04/2018 15:42 3033580573 5ELECTSTAY PAGE 03/03 PROPERTY TAX ADVISOR PAGE 03/04 Property Tax Advisors, Inc. 3090 S. Ialnalea Ct., Suite 204 Aurora, Colorado 80014 Phone (303)368-0500 Fax (303)368-0573 Email: ptuciv tox®propertytaxadvisor.net CONSULTANT - AGENCY AGREEMENT Property Owner: Morales Lewis D.,LL • County; Weld A7130298 Property Address 3025 el A,e. a Corporation _ a Partnership _Individuals a Trust The undersigned hereby appoints nud authorizes Property Tax Advisers, Inc, at{ its Agent add Consultant in the preparation and execution of 4 real est .t0' valuation appeal(s) on behalf of the undersigned in tegard to the above eawiwrated propatty(fes) for the 2018 tax year and for the prior two years_ The undersigned further authorizes Property Tax Advisors, Ine,,.as Agent of the undersigned? to execute end cause to be filed an behalf of the undersigned, in the none of the undersigned, any and all documents misting to an appeal of the subject property 's(les') valuation(s). ' 111e a$reetnent is tnceeuted this q day of fog , Z0 BY. P sate; Ok,,t�,t ..._._ Telephone No.: '?7/q 610-1/614, Pax No.. �c/7 rills: q1 �<<E /4'1 /1/#:7;;>.€1,e", . (If Corporation, your title; (or) Owner, °mamal Partner, Lessee, Power of Attorney, Trustee, etc.) Kee. 11t6 Agent: PROPERTY TAX ADVISORS, INC. 3090 South Jamaica Court, Suite 204 Aurora, Colorado 80014 TEL: (303)368-0500; FAX: (303)368-0573 Email: ptadvisor@propertytaxadvisor.net Subject: APPEAL OF REAL PROPERTY VALUATION Tax Year: 2017 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: 3/1/18 Photograph(s) of Subject Property Correlation and Conclusions Income Approach Market Sales Cost Approach X Salient Facts PETITIONER'S FINAL ESTIMATE OF VALUE: ASSESSOR'S VALUE: at ** ** 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 request 23% of the actual value be assessed at the residential rate. 2016 January February March April May June July August September October November December Total Total Revenue 30 -Day Stay Revenue $ 62,266 $ 16,658 $ 53,260 $ 8,682 $ 60,978 $ 9,847 $ 76,512 $ 15,626 $ 61,617 $ 10,638 $ 75,260 $ 14,506 $ 82,662 $ 10,323 $ 94,643 $ 11,889 $ 94,181 $ 27,429 $ 86,271 $ 27,382 $ 90,462 $ 27,465 $ 73,549 $ 26,737 $ 911,661 $ 207,182 % Revenue from 30 -Day Stays 22.73% DR 0100 (0945/13) COLORADO DEPARTMENT OF REVENUE Denver, CO 802610013 www.TarCatado.com Signed under pansty el per)ey In the second degree. Colorado Retail Sales Tax Return Departmental Use Only Signature Date ta+Nroorvrt 01/13/16 1IIIIII4I1a oIipl l null!! p SSN 1 SSN 2 FEIN4010 20-8480142 Last Name or Business (fame Lewis D Morales, LLC DBA Select Stay Hotel First ilamo Middle Initial Address 3025 8th Avenue Oily Evans Stale CO Zip 80620 0021-100 Phone (970) 356-2180 1. Gross Safes and Services for this sitollocation only (include bad debts prevlouslydeducted) • (14) 62,266 00 Colorado Account Number 02867565-0000 Period irsarrv-mwrrl 12/15 -12/15 2. Deductions (nontaxed sales): a, Sales to other licensed dealers, for resale • (2a'4) 00 Due Date Othvooryv) 01/20/16 Location/Aids Code 03-0041 b. Other deductions (from page 2) • (2b.4) 16, 658 00 Mark here if this is an Amended Return • c. Total (add tines 2a & 2b) 16 t 658 00 County/MTS City/LID Special District Slate 3. Net sates: (line 1 minus line 2c) • (3-1) 00 (3.2) 00 (3.3) 00 (344) 4 5 , 6 08 00 a. Sales out of taxing area • (3a.1) 00 (3e.2) 00 (3a4} 00 (3a-4) 00 (3b•2) 00 (3b4) 00 (3b.4) 0 00 b. Exemptions (list on page 2). • (3b.1) 00 (3c-4) 00 a. Overpayment from previous return • (301) 00 (3c-2) 00 (3c-3) 00 4. Net taxable sales (line 3 minus a,b,& a) 00 00 00 45 , 60 8 00 0. 02 90 v) Tax Rate 5. Amount of sales tax 00 00 00 1, 323 00 (6.3) 00 (8.4) 00 6. Excess tax collected • (6.1) 00 (6.2) 00 7. Total (add lines 5 & 6) 00 00 00 1, 323 00 0 B. a. Service fee rate b. Service lee allowed vendor (only If paid on or before duo dale) • 0. 033 3 (0.1) 00 (8-2) 00 (0.3) 00 (84) 44 00 1, 27 9 00 9. Sales tax due (line 7 minus line 8b) 00 00 00 (10.2) 00 (104) 00 (10.4) 00 10. Tax on $ • (10.1) 00 11. Total tax due (add lines 9 & 10) • (11-1) 00 (11.2) 00 (114) 00 (11.4) 1, 2 79 00 (124) 00 12. Penalty: a (12.1) 00 (12.2) 00 (32-3) 00 13. Monthly interest rate times tine 11 .0026 • (13.1) 00 (13.2) 00 (13.3) 00 (13.4) 00 14. Total each tax (add lines 11, 12, & 13) 00 00 00 1,279 00 The roroaayr ca�xaA yes dtadt to e ens Ca A t'.zcvo&c barhhg t ansad t Yotr a ataemay as9 ttyul Ssamed r ,fib the grata earraalai gaur ei roller 1fyy'cv, ed' reeve it IO�ISt�fGlYltOr,,,�,�tiilLll, 1110 DEpa�otnek�nue araf Wr{St it paymsnterrantcheykcmyothanxamount elewcttary. 15. Total Amount Owed Ell f aid by EFT (add alcahimnsontine 14) (355) ,1_,_____,__Q__ ,00 OR 0100 (09105113) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261.0013 www.TexColoredo.com II�I�If�lollllillli�l�il�lilfal� 14010O 29999 Colorado Retail Sales Tax Return Deductions and Exemptions Schedule: Colorado Account Number 02867565-0000 Period wwrs, vy't 12/15--12/15 Name Lewis D Morales, LLC DBA Select Stay Hotel Part A —Deductions 2B. Other Deductions must be itemized in the schedule below. 1. Service sales (A1-1) a 00 2. Sales to governmental agencies, religious or charitable organizations (A2.1) 0 00 3. Sales of gasoline (A3-1) 00 4. Sales of drugs by prescription and prosthetic devices (A4.1) 00 5. Trade-ins for taxable resale (A6.1) 00 6. Bad debts charged -off, returned goods, trade discounts and allowances where tax was paid (cash discounts are not allowed) (A8.1) 00 7. Cost of utilities, excluding tax (A7-1) 00 8. Sales of agricultural compounds and pesticides (A8.1) 00 9. Other (explain) Rooms rented more than 30 days and misc non-taxable (A0.1) 16,658 00 Total add lines 1 through 9 (enter here and on line 2b of the return) Total 16 , 658 00 Part B --Exemptions 3B. Enter total State Exemptions and applicable Local Exemption on line 3b. 1. Food, including food sold through vending machines CountvlMTS (01.1) 00 City/LID Special District State (81.2) 00 (81-3) 00 (81.4) 00 2. Machinery (82-1) 00 (82.2) 00 (82.3) 00 (82-4) 00 3. Electricity (d3-1) 00 (83.2) 00 (83.3) 00 (83.4) 00 4. Farm Equipment (84.1) 00 (84.2) 00 (84.3) 00 (84.4) 00 5. Sales of low -emitting vehicles, etc. (85-1) 00 (85.2) 00 (064) 00 (86.4) 00 6, School related sales (86-1) 00 (66.2) 00 (86.3) 00 (06.4) 00 7. Cigarettes (87-1) 00 (87-2) 00 (87.3) 00 (67-4) -NIA- 00 8. Renewable energy components (88.1) . 00 (88.2) ____. 00 (88-3) 00 (08.4) (69.4) 0 00 00 9. Other (explain) (89-1) 00 (89.2) 00 (80-3) 00 10. Total (enter here and on me 3b of the return) 00 00 00 0 00 DR 0100 (09/05/13) COLORADO DEPARTmeNT OF REVENUE Denver, CO 80261.0013 wtinv.TexCoraedo.com signed under penalyof perjury int o second degree. Colorado Retail Sales Tax Return Departmental Use Only Signature Date (etrri0Dryr)02 / 17 /16 I:9I II IIIp IM IN I IiIIIRE'I SSN 1 SSN 2 FEIN 20-8480142 UU 19999 Last Name or Business Name Lewis D Morales, LLC DBA Select Stay Hotel First Name Middle Initial Address 3025 8th Avenue City Evans Slate CO Zip 80620 0021-100 Phone (970) 356-2180 1. Gross Sales and Services for this site/location only (include bad debts previously deducted) 0 (1"'!) 53,260 00 Colorado Account Number 02867565-0000 Period (6evyy-crony) 01/16 — 01/16 2. Deductions (nontaxod sales): a. Sales to other licensed dealers, for resale 0 (2a-4) 00 oue Dale pttlmovnv) 02/20/16 LocatlonMuris 03-0041 Code b. Other deductions(frompage2) • o (s62) 8, 682 00 Mark here if this Is an Amended Return • ® c. Total (add lines.2a & 2b) 8 , 682 00 CountylMTS City1LID Special District State 3. Net sates: (line i minus line 2c) • (3-1) 00 (3.2) 00 �3.3) 00 (3.4) 44 , 5 78 00 a. Sales out of taxing area • (3a•1) 00 (3a•2) 00 (3a•3) 00 (3a-4) 00 b. Exemptions (list on page 2). • (3b.1) 00 (3b-2) 00 (3b.3) 00 (3b-4) 0 00 c. Overpayment from previous return • (301) 00 (3c-2) 00 (3c.3) 00 00 (3c•t) 44 , 578 00 00 4. Net taxable sales (lino 3 minus a,b,& c) 00 00 0 Tax Rate 0 .0 2 9 0 5. Amount of sales tax 00 00 00 1, 2 93 00 0. Excess tax collected • (6.1) 00 (6.2) 00 (6-3) 00 (6-4) 00 7. Total (add lines 5 & 6) 00 00 00 1, 2 93 00 0,) 8, a, Servlce fee rate 0.. 03 3 3 b. Service too allowed vendor (only If paid on Of before duo date) • (6-1) 00 (8-2) 00 (8-3) 00 (8.4) 4 3 00 9. Sates tax due (line 7 minus line eb) 00 00 00 - 1, 2 5 0 00 10. Tax on $ • (10.1) 00 (10.2) 00 (10.3) 00 (10.4) 00 11. Total tax due (add lines 9 & 10) • (11-1) 00 (11-2) 00 (11-3) 00 (11.4) 1, 2 5 0 00 12. Penalty; 0 (12-1) 00 (12-2) 00 (12-3) 00 (12-4) 00 13. Monthly interest rate times line 11 .0026 • (13.1) 00 (13.2) 00 (13.3) 00 (134) 00 14. Total each tax (add lines 11, 12, & 13) 00 00 00 1, 2 5 0.00 The Stale may oorrrrerll }nil chock to a one fire electrode Way t ansec%aa Yaw mayboieh"aiascmasthessmadavr nd& iha &Ilerem'.rt yardwcc"a"erbar�tut r ro'od�eic're eddua to insvadent a mooncalf ftws, the Dapa.9tant elRemrw may wed" payment oaoutfie* ;oreyew hark mad crecrrcrkwsy. 16. Total Amount Owed (� Paid by EFT lid (add al columns on line 14) (355) 1, 250 .00 DR 0100 (09105113) COLORADO DEPARTMENT OF REVENUE Denver, CO 8026/.0013 went TexColorado.corn I�irIEUIII�tftlGl��ili f' I��t,G��ll� �� 140100 29999 Colorado Retail Sales Tax Return Deductions and Exemptions Schedule: Colorado Account Number 02867565-0000 Period gureman9 01/16--01/16 Nemo Lewis D Morales, LLC DBA Select Stay Hotel Part A --Deductions 2B. Other Deductions must be itemized in the schedule below. 1. Service sales (A14) 0 00 2. Sales to governmental agencies, religious or charitable organizations (A2-1) 0 00 3. Sales of gasoline (A3.1) 00 4. Sales of drugs by prescription and prosthetic devices (A4-1) 00 5. Trade-ins for taxable resale (A6-1) 00 6. Bad debts charged -off, returned goods, trade discounts and allowances where tax was paid (cash discounts are not allowed) (A6-1) 00 00 7, Cost of utilities, excluding tax (A7.1) 8. Sales of agricultural compounds and pesticides (Atm) _ _ 00 00 00 9. Other (explain) Rooms rented more than 30 days and misc non-taxable (Aa1)._ 8,682 Total add lines 1 through 9 (enter here and on line 2b of the return) Total 8 , 682 Part B ---Exemptions 3B, Enter total State Exemptions and applicable Local Exemption on line 3b. 1. Food, including food sold through vending machines County/WITS City/LID (61.2) 00 Special District State iD1.1) 00 (614) 00 (61.4) 00 2. Machinery (62.1) 00 (62.2) 00 (82-3) 00 (62.4) 00 3. Electricity (83.1) 00 (83-2) 00 (83-3) 00 (83-4) 00 4. Farm Equipment (64.1) 00 (84.2) 00 0643) 00 (84.4) 00 5. Sales of low -emitting vehicles, etc. (05--0 00 (66.2) 00 (864) 00 (864) 00 6. School related sales (86.1) 00 (86-2) 00 (66.3) 00 (86.4) 00 7. Cigarettes (67-1) 00 (87-2) 00 (67-3) 00 (87.4) - N/A - 00 8. Renewable energy components (01)-1) - 00 (88.2) 00 (88-3) 00 (88.4) _ 00 9. Other (pi:pfain) (Be -1) 00 (89-2) 00 (60-3) 00 (69.4) 0 00I 00 1 d. Total (enter here and on rine 3b or the ream) 00 _ 00 00 0 OR 0100 (09105113) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261.0013 wrnv. TarCotorado.com signed under panaly of perjury In lha second degree. Colorado Retail Sales Tax Return Departmental Use Only Signature Date IMM10prvY) 03/17/16 II (� y p kpp r ]IIII I1i1f11IIII9fI9 g g1.I1 SSN 1 SSN 2 PEIN 20-8480142 ,1i14IIIt1,H Last Name or Business Name Lewis D Morales, LLC DBA Select Stay Hotel First Name Middle Initial Address 3025 8th Avenue City Evans State CO Zip 80620 0021-100 Pion (970) 356-218O 1. Gross Sales and Services for this sltellocation only (include bad debts previously deducted) 0 (1'4) 60 , 978 00 Colorado Account Number 02867565-0000 Period p.euYY•summ 02/16 —02/16 2. Deductions (nontaxed sales): a. Sales to other licensed dealers, for resale o (2a-4) 00 Due Dale (raeraorri) O3/2O/16 Location/Juris Code 03.0041 b. Other deductions (from page 2) o (2b.4) 9,847 00 Mark here if this is an Amended Return e c. Total (add )Ines 2a & 2b) 9 847 00 County/MTS _ City/LID Special District State 3. Net safes: (line 1 minus line 2c) • (3.1) 00 (3.2) 00 (3-3) 00 (3.A 51, 131 00 a. Sales out of taxing area • (3a-1) 00 _ (31.2) 00 (3a-3) 00 (3a•4) 00 b. Exemptions (fist on page 2). a (3b•1) 00 (3b-2) 00 (3b-3) 00 (3b•4) 0 00 o. Overpayment from previous return • (3c-1) 00 (3c-2) 00 (3c-3) 00 (3c-4) 51, 131 00 00 4. Net taxable axles (line 3 minus a,b,& c) 00 00 00 Tax Rate _ 0 .0290 6. Amount of sales tax 00 00 00 1, 4 8 3 00 6. Excess tax collected a (6a) 00 (s-2) 00 (6-3) - 00 (6.4) 00 7. Total (add lines 5 & 6) O 8. a. Service fee rate b. Service foe allowed vendor (only if paid on or before duo dale) • 00 00 00 1, 483 00 0.0333 (8.1) 00 (8.2) OQ (8.3) 00 (sect) 4 9 00 9. Sales tax due (line 7 minus line Sb) 00 00 00 1, 4 3 4 00 10. Tax on $ L(10.1) 00 (10.2) 00 (10.3) 00 (10.4) 00 11. Total tax due (add lines 9 & 10) 0 (11.1) 00 (11.2) 00 (11-3) 00 (111) 1, 4 34 00 12. Penalty: • (12-1) 00 (12-2) 00 (12-3) 00 (12-4) 00 13. Monthly interest rate times line i1 .0026 • (13.1) 00 (13.2) 00 (13.3) 00 (13.4) 00 14. Total each fax (add lines 11, 12, & 13) 00 00 00 1, 434 00 TbsSlatemay tarntdyewdsttononormeitch1ro,,a ban! aansac6art Yawb 'fiec oe'frml dutdsdasurt litheee Hachp reo edl�nyuw ga urlieenerloi• talnotbare kind rliedcisreedtatt tatMrarrDMtar fJM1d9, UA D2QM1MMl0(t�lHefA74ln3f f 6ltEtl line payrrexawn tern balm( bark email eixtror,eat'r. �v { 16. Total Amount Owed EI a Paid by EFT (add al columns online 14) (355) 1,434 .00 DR 0100 (09105113) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261.0013 isww.. TexColoredo. com III I1IJIFIIII NIIIIIIIIIIII11I l II II IIIIII 140100 29999 Colorado Retail Sates Tax Return Deductions and Exemptions Schedule: Colorado Account Number 02867565-0000 Period iw.wy wr.mnry 02/16-02/16 Name Lewis D Morales, LLC DBA Select Stay Hotel Part A —Deductions 2B. Other Deductions must be itemized in the schedule below. 1. Service sales (Al -1) 0 00 2. Sales to governmental agencies, religious or charitable organizations (A2-1) 0 00 3. Sales of gasoline (A3.1) 00 4. Sales of drugs by prescription and prosthetic devices (AM1) 00 5. Trade-ins for taxable resale (Ali-i) 00 6. Bad debts charged -off, returned goods, trade discounts and allowances where tax was paid (cash discounts are not allowed) (A6"1) 00 7, Cost of utilities, excluding tax (Am) 00 00 8. Sales of agricultural compounds and pesticides (A6-i) 9.Other (explain) Rooms rented more than 30 days and misc non-taxable (A9.1) - 9,847 00 Total add lines 1 through 9 (enter here and on line 2b of the return) Total 9, 847 00 Part B --Exemptions 3B. Enter total State Exemptions and applicable Local Exemption on line 3b. 1. Food, Including food sold through vending machines Countv1MTS City/LID I Special District State (01.1) - 00 (81.2) 00 (81.3) 00 (81-4) 00 2. Machinery (132.1) _ 00 (ai-:) 00 (824) 00 (B2-4) 00 3. Electricity (B3-1) 00 (83.2) 00 (83-3) 00 (83.4) 00 4. Farm Equipment (84.1) 00 (84.2) 00 (84-3) 00 (B4.4) 00 5. Sales of low -emitting vehicles, etc. (86.1► 00 (8b.2) 00 (86-3) 00 (66.4) 00 6. School related sales (136.1) 00 (86.2) 00 (864) 00 (864) 00 7. Cigarettes (87.1) 00 (B7.2) 00 (07.3) 00 (87.4) - N(A - (88.4) 00 00 S. Renewable energy components (88-1) 00 (88.2) 00 (88-3) 00 9. Other (explain) (89.1) 00 (89.2) 00 (89-3) 00 (09.4) 0 00 10. Total (enter here and on Eno 3b of the return) 00 _ 00 00 0 00 OR 0100 (00105113) COLORADO DEPARTMENT OF REVENUE Denver, CO 60261.0013 now.. TaxCoJora do.corn Signed Wet panalyolpetluryintheseconddefree. Colorado Retail Sales Tax Return Departmental Use Only Signature -- Date(Mruaorrv) 04/09/16 J 1 I� i �({j rs� ICI IIIIIIIII1IIIIIIIIIN LIIII 1ItI�IiII?IH SSN 1 SSN 2 FEIN 20-8480142 140100 19999 Last Name or business Name Lewis D Morales, LLC DBA Select Stay Hotel First Name Middle initial Adaress 3025 8th Avenue City Evans State CO Zip 80620 0021-100 Phone (9 70) 356-2180 1. Gross Safes and Services for this site/location only (include bad debts prevlously deducted) 0 (1.4) 76 , 512 00 Colorado Account Number 02867565-0000 Period ousirr.:awro 03/16 -03/16 2. Deductions (nontaxed sales): a. Sales to other licensed dealers, for resale • (tad) 00 Due (Sate (+arvoerrr) 04/20/15 Locationliuris Codo 03-0041 b. Other deductions (from page 2) • (2b.4) 1.5,626 00, Mark here 7 this Is en ( Amended Return a ` I c. Total (add lines 2a & 2b) 15 , 626 00 CountylMTS _ - City/LID .. Special District State 3. Net sales: (line iminus line 2c) • (3-1) 00 (3 2 00 (3.3) 00 (3.4) 60,886. 00 a. Sales out of taxing area o (3a-1) 00 (3a-2) 00 (3a-3) 00 (3a.4) 00 b. Exemptions (list on page 2). • (3b-1) 00 (3b-2) 00 (3b-3) 0.0 (3b-4) 0 00 00 a. Overpayment from previous return • (3c-1) 00 (3c-2) 00 _ (3c-3) 00 (3c-4) 4. Net taxable sates (line 3 minus a,b,& c) 00 00 00 60,886 00 Tax Rate 0 . 02 90 5. Amount of sales tax 00 00 00 1,766 00 6. Excess tax collected • (6.1) 00 (6.2) 00 (6-3) 00 (s-4) 00 7. Total (add tines 5 & 6) 00 .. 00 00 1, 76 6 0.0333 00 6. a. Service fee rate b. Service fee allowed vendor (only if paid on or before duo date) • e-1) - 00 (8-2) 00 (8.3) 00 (8.4) 59 00 0. Sales tax due (tine 7 minus line 8b) 00 00 00 1,707 00 10. Tax on $ a (10.1) - 00 (10-2) 00 (10-3) 00 (10.4) 00 11. Total tax due (add lines 9 & 10) 0 (11-1) 00 (11.2) 00 (11.3) 00 (11.4) 1, 7 07 00 12. Penalty: 0 (12-1) 00 _ (12-2) 00 (12-3) 00 (12-4) 00 13. Monthly Interest rate times Eno 11 .0026 0 (13.1) 00 (13-2) 00 (13-3) 00 (13.4) 00 14. Total each tax (add lines 11, 12,E&d 13) 00 00 00 1,707 00 yirceurttekrArioratritrai"' '° i if b rig= u�oa�elbrAa.Ono tkyaMxnic�nsverx,a wired Graem dreety ken your bank account ertd ode* tr' u r fir, mad tot<d s» 16. Total Amount Owed n Paid by EFT (add all columns on line 14) (355) 1, 7 07 , 00 DR 0100 (09105/13) COLORADO DEPARTMENT OF REVENUE Deem, CO 00261.0013 wieet rexColoredo. can III IluJIIOIIIIII[I I IIIII Ill≥II�IQ 140100 29999 Colorado Retail Sales Tax Return Deductions and Exemptions Schedule: Colorado Account Number 02867565-0000 Period (he.VYY-UN1YY) 03/16--03/16) Narita Lewis 0 Morales, LLC OBA Select Stay Hotel Part A —Deductions 2B. Other Deductions must be itemized in the schedule below. 1. Service sales (A1.1) 0 00 2. Sales to governmental agencies, religious or charitable organizations (A2-1) 0 00 3. Sales of gasoline (A3-1) 00 4. Sales of drugs by prescription and prosthetic devices (M-1} 00 5. Trade -Ins for taxable resale (A6-1.) 00 6. Bad debts charged -off, returned goods, trade discounts and allowances where tax was paid (cash discounts are not allowed) (AB -11 00 7. Cost of utilities, excluding tax (AY -1) 00 8. Sales of agricultural compounds and pesticides (A8.1} 00 9. Other (explain) Rooms rented more than 30 days and misc non-taxable (A9-1) 15,626 0 Total add lines 1 through 9 (enter hero and on line 2b of the return) Total 15,626 00 Part B —Exemptions 3B. Enter total State Exemptions and apprcabie Local Exemption on line 3b. 1. Food, Including food sold through vending machines 2. Machinery County/MTS CitylLID Special District State (81.1) 00 (01.2) 00 (81.3) 00 (01.4) 00 (02-1) 00 (02.2) 00 (62-3) 00 (824) 00 3. Electricity (83-1) 00 (83.2) 00 (83-3) (84.3) 00 00 (03-4) (84.4) 00 00 4. Farm Equipment 5. Sales of lour -emitting vehicles, etc. (e4-1) 00 (84.2) 00 (as -1) 00 (05.2) 00 (B5-3) 00 (86.4) 00 6. School related sales 7. Cigarettes (86.1) 00 (86.2) 00 (664) 00 (86.4) 00 (87-1) 00 (or -2) 00 (81.3) 00 (874) - N/A - 00 8. Renewable energy components ri3B-1) - -� 00 (08-2) 00 (88-3) 00 (88.4) (89.4) 0 00 00 9. Other (xplain) (89-0 00 (89.2) 00 (80-3) 00 10. Total (enter here end on me 3h of the roturn) 00 - - 00 - _ - 00 0 00 DR 0100 (00/05113) COLORADO DEPARTMENT OF REVENUE Denver. CO 80281.0013 iwew. iaxCo.'orado.com Signed ender penatyefperµxyinthe second degree. Colorado Retail Sales Tax Return Departmental Use Only Signature Date (Mruowvr) I� gill gill Igtii05/12/16 SSN 2 FEIN 20-8480142 iiptp�0 1919t99�1ISSNt Last Name or Business Name Lewis D Morales, LLC DBA Select Stay Hotel First \rams Middle initial Address 3025 8th Avenue City Evans Stale CO Zip 80620 0021-100 Phone (970) 356-2180 1, Gross Sales and Services for this site/location only (include bad debts previously deducted) O (1.4) 61,617 00 Colorado Account Number 02867565-0000 Period (MMJYYMMMJYY) 04/16 --04/16 2. Deductions (nontaxsd sales): a. Sales loother licensed dealers, for resale o (2a-4) 00 Due Date (t1MrDOrrr) 05/20/16 Locatlon/Juris Code 03-0041 b. Ctherdeductlons (from page 2) o (2b-4) 10,638 00 Mark here if this is an Amended R eturn o LJ c. Total (add lines 2a & 2b) 1O , 638 00 Count /MTS,._ City/LID. Special District State 3. Net sales: (line i minus line 2c) a 3• ) 00 (3.2) 00 00 .4) 50 , 979 00 a. Sales out of taxing area a (3a-1) 00 (3a•2) 00 (3a-3) 00 (3a•4) 00 b. Exemptions (list on page 2). a (3b•1) 00 (3b.2) 00 (3b-3) 00 (3b-4) 0 00 c. Overpayment from previous return a (3c-1) 00 (3c-2) 00 (3c-3} 00 (3c-4) 00 4. Net taxable sales (line 3 minus a,b,& c) 00 00 00 50 , 979 00 o Tax Rate 0.0290 5. Amount Of sales tax 00 00 00 1, 478 00 6. Excess tax collected a 00 1 1 (8.3) 00 (8.4) 00 7. Total (add lines 5 & 6) 00 11 00 1 478 00 O 8. a. Service fee rate 0. 0333 b. Service fee allowed vendor (only iI paid on or before duo data) • (0•i) 00 (8-2) 11 11 49 11 9. Sales lax due (line 7 minus Tine 8b) 00 00 1,429 00 10. Tax on $ a 00 00 00 00 00 11 (11.3) 1, 429 F 00 12. Penalty; o00 11 (12-3) 1113. Monthly interest rate Urns{13-1) line 11 00 (13-2) ii (13.3) 11 14. Total each tax 00 00 00 1,429 00 lbe Ma% may morel your check to a ono fme *client ' le buffers' ci uneecie4 We. [he ; tockitransecor. ad di. the 1b. Total Amount Owed �?� Paid by EFT (add all columns ar line 14) (355) 1 429 1 1 DR 0100 (09/05/13) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261.0013 wvnv.TaxCo/aedo.com IIIIIUIilH IliIlIIII I II II I IH1III 140100 29999 Colorado Retail Sales Tax Return Deductions and Exemptions Schedule: Colorado Account Number 02867565-0000 Period Ne M nn1 04/16--04/16 Name Lewis D Morales, LLC ABA Select Stay Hotel Part A --Deductions 2B. Other Deductions must be itemized in the schedule below. 1. Service sales (A1-1) 0 00 2. Sales to governmental agencies, religious or charitable organizations (A24) 0 00 3. Sales of gasoline (A34) 00 4. Sales of drugs by prescription and prosthetic devices (A4.1) 00 5. Trade-ins for taxable resale (AS -1) 00 - -- 6. Bad debts charged -off, returned goods, trade discounts and allowances where tax was paid (cash discounts are not allowed) _ - (n6 i) 00 7, Cost of utilities, excluding tax (A7.1) 00 00 8. Sales of agricultural compounds and pesticides (A6-1) 9. Other (explain) Rooms rented more than 30 days and misc non-taxable (A9-1) 10,638 00 Total add lines 1 through 9 (enter here and on line 2b of the return) Total 10,638 00 Part B —Exemptions 3B. Enter total State Exemptions and applicable Local Exemption on line 3b. 1. Food, Including food sold through vending machines County/MTS City/LID Special District State (81.1) 00 (81.2) 00 (814) 00 (814) 00 2. Machinery (82.1) - 00 (82-2) 00 (824) 00 (82-4) 00 3. Electricity (83.1) 00 (83.2) 00 (834) 00 (834) 00 4. Farm Equipment (84-1) 00 (84.2) 00 134.3) 00 (844) 00 5. Sales of low -emitting vehicles, etc. (85-1) 00 (86.2) 00 (864) 00 (86.4) 00 6. School related sales (83.1) 00 (86-2) 00 (864) 00 (061) 00 7. Cigarettes (87-1) 00 (87-2) (08.2) 00 00 (87-3) (80-3) 00 00 (87.4) - NIA - 00 8. Renewable energy components (33.1) 00 (88 4) 00 9. Other (explain) (09-1) 00 (89.2) 00 (89.3) 00 (89.4) 0 00 10. Total(enterhere and on line3b of the return) 00 00 00 0 00 DR 0100 (09/05/13) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261.0013 mm'. TaxCoforedo.com Signed older pens)y amply In the second degree. Colorado Retail Sales Tax Return Departmental Use Only Signature Date (mown" 06/14/16 (p} [(� I fy EII# IIIIIIIIIIII19IIIIIt1UIiI1l1��I�tlAiII ( r �] (�ij( g SSN 1 SSN 2 FEIN 20-8480142 140100 19999 Last Name or Business Name Lewis D Morales, LLC ABA Select Stay Hotel First Name Middle Initial Address 3025 8th Avenue City Evans State CO Zip 80620 0021100 Phone (970) 356-2180 1. Gross Sales and Services for this site/location only (Include bad debtsprevlous deducted) 0 (t4) 75,260 00 Colorado Account Number 02867565-0000 Period p,surt-Avvv) 05/16 -05/16 2. Deductions (nontaxod sales): a. Sales to other licensed dealers, for resale a (2a-4) 00 Ouebate (tuuaem) 06/20/16 Locatiordfuris Code 03-0041 b. Other deductions (from page 2) 0 (2b-4) 14, 506 00 Mark here if this Is an Amended Return a 1 c. Total (add lines 2a &2b) 14 , 506 00 County/MIS City/LID Special District State 3. Net sates: (line 1 minus line 2c) a (3.1) 00 (3.2) 00 3.3) 00 1341 60 , 754 00 a. Safes out of taxing area • (3a-1) 00 (3a.2) 00 (3a4) 00 (3a-4) 00 b. Exemptions (list on page 2). • (3b.1) 00 (31x2) 00 (3b4) 00 (3b-4) 0 00 e. Overpayment from previous return _ • (3"A) 00 (3c-2) 00 (3c-3) 00 (3c-4) 00 4. Net taxable sales (line 3 minus a,b,& 0) 00 00 00 60 , 754 00 O Tax Rate 0.02 90 6. Amount of sales tax 00 00 00 1, 76 2 00 6. Excess tax collected • (8-1) 00 (8.2) 00 00 (8'3) 00 (8.4) 00 7. Total (add lines 5 & 6) 00 00 1, 762 00 O 8. o. Service fee rate 1 0.0333 b. Service fee allowed vendor (only It paid on or before duo dale) • (8.1) 00 (8.2) 00 00 (8.3) 00 (8.4) 59 00 9. Sales tax due (line 7 minus line 8b) 00 00 1, 703 00 10, Tax on $ • (10.1) 00 (10.2) 00 (10.3) 00 (10.4) 00 11. Total tax due (add lines 9 & 10) • (11.1) 00 (11.2) 00 (11-3) 00 (11.4) 1, 703 00 12. Penalty: 0 (12-1) 00 (12-2) 00 (12.3) 00 (12-4) 00 00 00 (13-2) 00 {134) 00 (13.4) 13. Monthly interest rate times line 11 .0026 • (13-1) 00 14. Total each tax (add lines 11, 12, & 13) 00 00 00 1, 703 1taStotomarc nveri}`xvdaditoaxgfm4Necironiban4hakaraacEsm 5arba* matin4 Sedases,astlwlamada reca-v.d�y 8re $tattUue ywrdackxtrotbeo&wcd.uroyaurrrlredrhre)adeddue to tosUTdeda xcoxyedhr-$s,U-aCopadrrantorfiesewomarcuedNa pyrrentvacntfrectllhnta}rwrbarkmad dectrorlea,°y � 16. Total Amount Owed 151 Paid by EFT (add an columns ontine14) (355) 1(703 ,00 DR 0100 (09105/13) COLORADO DEPARTMENT OP REVENUE Demo/. CO 80261.0013 wnnr.rnxColwedo.00n 940100 99999 111 Colorado Retail Sales Tax Return Deductions and Exemptions Schedule: Colorado Account Number 02867565-0000 Period 0,0.vrAtriir t 05/16--05/16 Name Lewis D Morales, LLC DBA Select Stay Rotel Part A --Deductions 2B. Other Deductions must be itemized in the schedule below. 1. Service sales (Al -1) 0 00 2. Sales to governmental agencies, religious or charitable organizations (A2-1 0 00 3. Sales of gasoline (A3-1) 00 4. Sales of drugs by prescription and prosthetic devices - (M -I) 00 5. Trade -Ins for taxable resale (A6.1) 00 6, Bad debts charged -off, returned goods, trade discounts and allowances where tax was paid (cash discounts are not allowed) (A8.1) 00 00 7. Cost of utilities, excluding tax (Al -1) 8. Sales of agricultural compounds and pesticides (A8.1) 00 9. Other (explain) Rooms rented more than 30 days and misc non-taxable (A9-1) 14,506 00 00 Total add lines 1 through 9 (enter here and on line 2b of the return) Total 14,506 Part B —Exemptions 3B. Enter total State Exemptions and applicable Local Exemption on line 3b. 1. Food, including food sold through vending machines CountylMTS City/LID Special District Stato toi=l) 00 (ei-z) 00 (a1-3) 00 (01-4) (132.4) 00 00 2. Machinery (132=1) 00 (02.2) 00 (024) 00 3. Electricity (s3-11 00 (133.2) 00 (83-3) 00 (83-4) 00 4. Farm Equipment (84.1) 00 (84.2) 00 (04-3) 00 (84.4) 00 5. Sales of low -emitting vehicles, etc. (as -1) 00 (85.2) 00 (864) 00 (86.4) 00 6. School related sales (86-1) 00 (06.2) 00 (86-3) 00 (86.4) 00 7. Cigarettes (87-1) 00 (8r-2) 00 (07-3) 00 (01.4) - N/A - (88.4) 00 00 8. Renewable energy components (88.1) __ 00 (86.2) 00 (88-3) 00 9. Other (explainl (094) 00 (89.2) 00 (894) 00 (89.4) 0 00 10. Total (enter here end on cne 3b or the return) 00 _.._ 00 00 0 00 DR 0100 (09105/13) COLORADO DEPARTMENT OF REVENUE Denver. CO 80251.0013 v.we+ Ta The Co Fe rodo.com Signed under pen atyerpe4uryinthe second degree. Colorado Retail Sales Tax Return Departmental Use Only Signature Datermmoor vi 07/13/16 ( uj (� (fit j III Ohl 11:8h �g SSN 1 SSN 2 FEIN 20-8480142 ItlhIIII 0100 IIIIi�I�9191E1J Last Name or Business Name Lewis O Morales, LLC DBA Select Stay Hotel First game Middle initial Address 3025 8th Avenue City Evans Stale CO Zip 80620 0021-100 Phone (970) 356-218 0 1. Gross Sales and Services for this site/location only (include bad debts previously deducted) • (1-d) 82 , 662 00 Colorado Account Number 02867565-0000 Period pwrrYMrrnrl 06/16 --06/16 2. Deductions (nontaxod sales): a. Sales to other licensed dealers. for resale • (2a-4) 00 Due Date p wervvv) 07/20/16 Location/Juris Code 03-0041 b. Olher deductions (from page 2) • (2b•4) 10,323 00 Mark here if this Is an Amended Return s E c. Total (add lines 2a & 2b) 10, 323 00, County/MIS City/LlD Special District State 3. Net sales: (line d minus line 2c) • (3d) 00 (342 _ ` 00 (3-3) 00 (3-4) 72 , 339 00 a. Sales out of taxing area • (3a-1) 00 (3a•2) 00 (3a-3) 00 (3a-4) 00 b. Exemptions (list on page 2). • (3b-1) 00 (3b•2) 00 (311.3) 00 (3b.4) 0 00 c. Overpayment from previous return • (3c•1) 00 (3c-2) 00 (3c4) 00 (3c-4) 72 , 339 00 00 4. Net taxable sales One 3 minus a,b,& c) 00 00 00 Tax Rate 0 .0290 6. Amount of sales lax 00 00 00 2 098 00 6. Excess tax collected • (6-1) 00 (6.2) 00 (8-3) 00 (8-4) 00 7. Total (add lines 5 & 6) 00 00 00 2 , 098 00 O 8. a. Service fee rate 0. 0333 (8.4) 70 00 b. Service fee allowed vendor (only if paid on or before duo dabs) • (8.11 00 (0-2) 00 (84) 00 9. Sales tax due (line 7 minus line 8b) 00 00 00 2 , 028 (10.4) 00 00 10. Tax on $ • (10.1) 00 (10.2) 00 (10-3) 00 11. Total tax due (add lines 9 & 10) • (11-1) 00 (11.2) 00 (114) 00 (11-4) 2 , 028 00 12. Penalty: • (12-1) 00 (12-2) 00 (12.3) 00 (12-4) 00 13. Monthly interest rate times line 11 .0026 • (13.1) 00 (13.2) 00 713.3) 00 (13-4) 00 14. Totaleach lax (add lines 11, 12, & 13) 00 00 00 2,028 00 Litt"cer byes drat leamefmadectrani lrarn&c n. eccevr4an/badobledarcad/arKeesamed mce ''dtr pea StelaIfcdrrerle3.youdIDAwlnolberfumed.liyau mieatsre eddua lahsuPa'entortnoo*ted b .ds. p.A D4mt ni drum „wed the payrceMarrauni6reedffromyobrbarkss-oast eclraduty. 15. TotalAmountOwed bf+l Paid by EFT (add ailcolumnsonline 14) (355) 2 028 .00 DR 0100 (09105/13) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261.0013 www.TaxCo/aeciaco n IIIIIUI1H1IIII Ill IIiiH1EI II IHII 140100 29999 Colorado Retail Sales Tax Return Deductions and Exemptions Schedule: Colorado Account Number 02867565-0000 Period(uNmewrty} 06/16--06/16 Name Lewis D Morales, LLC DBA Select Stay Hotel Part A —Deductions 25, Other Deductions must be itemized in the schedule below. 1. Service sales (A1-1) 0 00 2. Sales to governmental agencies, religious or charitable organizations (A2.1) 0 00 3. Sales of gasoline (A3-1) 00 _ 4. Sales of drugs by prescription and prosthetic devices (A4.1) 00 5. Trade-ins for taxable resale (A6.1) 00 6. Bad debts charged -off, returned goods, trade discounts and allowances where tax was paid (cash discounts are not allowed) (A6.t) 00 7. Cost of utilities, excluding tax (AT -1) 00 8. Sales of agricultural compounds and pesticides (A6.1) 00 9.Other(explain) Rooms rented more than 30 days and misc non-taxable (A9.1) 10,323 00 Total add lines 1 through 9 (enter hero and on line 2b of the return) Total 10,323 00 Part B —Exemptions 35. Enter total State Exemptions and applicable Local Exemption on line 3b. 1. Food, including food sold through vending machines CountvlMTS City/LID Special District State (81.1)(81-2) 00 00 (91-3) 00 (91-4) 00 2. Machinery (82.1) - 00 (02.2) 00 (823) 00 (82-4) 00 3. Electricity (03.1) 00 (83-21 00 (833) (843) 00 00 (83.1) (84-4) 00 00 4. Farm Equipment (84.1) 00 (94.2) 00 5. Sales of low -emitting vehicles, etc. (8s-1)-1) 00 (85-2) 00 (98-3) 00 (85.4) 00 6. School related sales (98-1) 00 (86.2) 00 (86.3) 00 (964) 00 7. Cigarettes (87-1) 00 (87.2) 00 (81-3) 00 (87-4) _ NIA - 00 8. Renewable energy components (86.1) 00 (08.2) 00 (88.3) --(084) 00 00 9. Other (explain) (89-1) 00 (89-2) 00 (88-3) 00 (89-4) 0 00 10. Total (eider here end on me 3b or the return) 00 00 00 0 00 DR 0100 (09/05/13) COLORADO DEPARTMENT OF REVENUE Denver, CO 00261.0013 www. TasColomdo.co,n Shred urn penaty of perjny In the second degree Colorado Retail Sales Tax Return Departmental Use Only Signature Date (duuowwYY) 08/16/16 I1I1IIIIIIIII1IIIIIII IIIIII I919I1'11 SSN 1 SSN 2 FEIN 20-8480142 Last Name or Business Name Lewis D Morales, LLC DEA Select Stay Hotel First Jame Middle Initial Address 3025 8th Avenue City Evans State CO Zip 80620 0021-100 Phone (970) 356-2180 1, Gross Safes and Services for this site/location only (Include bed debts previously deducted) • (1.4) 94 , 643 00 Colorado Account Number 02867565-0000 Period 0,u.wy-bwny 07/16 -07/16 2. Deductions (nontaxod sales): a. Sates toother licensed dealers, for resale o (2s-4) 00 Due Date (meow() 08/20/16 Location/Judi-Code 03-0041 b. Other deductions (from page 2) • (2b-4) 11, 889 00 Mark here if this Is an Amended Return e Fl&.2b) c. Total (add tines 2a 11, 88 9 00 CountylMTS City/LID _ Special District State 3. Net sales: (line 1 minus line 2c) • (3.1) 00 (3.2j 00 1331 00 (3.4) 82 , 754 00 a. Sales out of taxing area • (3a-1) 00 (3a-2) 00 (3a-3) 00 (3e.4) 00 b. Exemptions (list on page 2). • (3b-1) 00 (36.2) 00 (3b-3) 00 (3b.4) 0 00 c. Overpayment from previous return • (3c-1) 00 (3e-2) 00 (3o-3) 00 (3c-4) 00 4. Net taxable sates (Ono 3 minus a,b,& c) 00 00 00 82 , 754 0.0290 00 O Tax Rate 5. Amount of sales tax 00 . 00 00 2,400 00 e. Excess tax collected • (0-1) 00 (s-2) 00 (0-3) 00 (0.4) 2 , 4 00 00 00 7. Total (add lines 5 & 8) 0 0. a, Service fee rate Ix Service fee allowed vendor (only if paid on or before due date) • 00 00 00 0.0333 le -1) 00 (4-2) 00 (8-3) 00 (8.$) 80 2 , 320 00 00 9. Sales lax due (line 7 minus line 86) 00 00 Q0 10. Tax on S • (10.1) 00 (10.2) 00 (10-3) 00 (10.4) 00 11.Totaltax due (add llnes9&10) o (11-1) 00 (11.2) 00 (11-3) 00 (11.4) 2, 320 00 12. Penalty: o (12-1) 00 (12.2) 00 (12-3) 00 (12.4) 00 13. Monthly interest rate times Una 11 .0026 • (13.1) 00 (03.2) 00 (13.3) 00 (13.4) 00 14. Total each lax (add lines 11, 12, & 13) 00 00 00 2 , 32 0 00 fle8tate mal ren41)Utr dtetk to a xa 0i5 etodronc barAisj vansac€an. Yaw bmuc91W nw b dst1ted *s eas y as tla same da receved Uu gc°'IK °)°rke tvb.rd'r0"f vygur`h,d" coded ' to iuUfraettla u}QoGtcled rends. th9 Depadrnent of Rer eewe may Wed the parnentarnawareai/traelwrra�caocamtc�edrordt. 15. Total Amount Owed �] Paid by EFT (add ail columns online 14) (355) 2, 320 .00 DR 0100 (09/05/13) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261.0013 tw. ToxColonedo.cortr Illi(il 11 1Ullil1ll11lll r[l1lll11IIIII 140100 29999 Colorado Retail Sales Tax Return Deductions and Exemptions Schedule: Colorado ccount Number 02867565-0000 Period og m mtm 07/16--07/16 Name Lewis D Morales, LLC DBA Select Stay Hotel Part A --Deductions 2B. Other Deductions must be itemized in the schedule below. 1. Service sales (A1-1) 0 00 2. Sales to governmental agencies, religious or charitable organizations (A2-1) 0 00 3. Sales of gasoline -A3.1) 00 4. Sales of drugs by prescription and prosthetic devices (A4-1) 00 5. Trade-ins for taxable resale (M6-1) 00 00 6. Bad debts charged -off, returned goods, trade discounts and allowances where tax was paid (cash discounts are not allowed) (A6.1) 7. Cost of utilities, excluding tax (A71) 00 8. Sales of agricultural compounds and pesticides (A8-1) 00 9. Other (explain) Rooms rented more than 30 days and misc non-taxable (A9 -t) 11,889 00 Total add tines 1 through 9 (enter here and on line 2b of the return) Total 11, 889 00 Part B --Exemptions 3B. Enter total State Exemptions and appfcabie Local Exemption on line 3b. 1. Food, Including food sold through vending machines County/MTS City/LID Special District State (D1-1) 00 (81.2) 00 (01-3) 00 (81.4) 00 2. Machinery (82-1) 00 (82.2) 00 (92-3) 00 (824) 00 3. Electricity (83.1) 00 (83.2) 00 (83.3) 00 (83-1) 00 4. Farm Equipment (84.1) 00 (84.2) 00 (84-3) 00 (84.4) 00 5. Sales of low -emitting vehicles, etc. (86-1) 00 (86.2) 00 (86-3) 00 (864) 00 6. School related sales (88-1) 00 (86.2) 00 (138.3) (87-3) 00 00 (864) (87.4) - N/A - 00 00 7. Cigarettes (0x.1) 00 (87-2) 00 8. Renewable energy components (88-1F 00 (88.2) 00 (88.3) 00 (884) 00 9. Other (explain) (09-1) 00 (B9.2) 00 (80.3) 00 (894) 0 00 10. Total (enter here and on rme 3b of the return) 00 00 00 0 00 Departmental Use Only OR 0100 (08118/14) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261-0013 vnnv. TaxCoorado.com Signed under penaty ol perjtay h t o seoor>3 degree. Colorado Retail Sales Tax Return Signature Date (MMIDD!YY) SSN 1 SSN 2 FEIN Last Name or Business Name SELECT STAY HOTEL First Name Middle Initial Address City State Zip 0Q21-101 Phone 1. Gross Sates and Services for this site/location only (Include bad debts previously deducted) • (1-4) 94181 Colorado Account Number Period (M4trYY-Mtvw) 08/31/16 2. Deductions (nontaxed sales): a. Sales to other licensed dealers, for resale • (2a-4) 0 Due Date (MMIDD/YY) 09/20/16 Location/hits Code 028675650000 b. Other deductions (from page 2) • (2b4) 27429 Mark here if this is an Amended Return • I c. Total (add lines 2a & 2b) 27429 County/MTS City/LID - Special District State 3. Net sales: (line 1 minus line 2c) • (3-1) 0 (3-2) 0 (3-3) 0 (3-4) 66752 a. Sales out of taxing area • (3a-1) 0 (3a-2) 0 (3a-3) 0 (3a-4) 0 b. Exemptions (list on page 2). • (3b4) 0 (3b-2) 0 (3b4) 0 (3b.4) 0 c. Overpayment from previous return • (3c4) 0 (3c.2) 0 (3c4) 0 (3c-4) 0 4. Net taxable sales (line 3 minus a,b,& c) 0 0 0 66752 Tax Rate 0 0 0 0.029 5. Amount of sales tax 0 0 0 1936 6. Excess tax collected • (6-1) 0 (6.2) 0 (6.3) 0 (0-4) 0 7. Total (add lines 5 & 6) 0 0 0 1936 8. a. Service fee rate 0 0 0 0.0333 b. Service fee allowed vendor (only If paid on or berore due date) • (8.1) 0 (8.2) 0 (8-3) 0 (8.4) 64 9. Sales tax due (line 7 minus line fib) 0 0 0 1872 10. Tax on S 0 • (10-1) 0 (10.2) 0 (10-3) 0 (10.4) 0 11. Total tax due (add lines 9 & 10) • (11-1) 0 (11-2) 0 (113) 0 (114) 1872 12. Penalty: • (12.1) 0 (12-2) 0 (12-3) 0 (124) 0 13. Monthly interest rate times line 11 .0025 • (134) 0 (13.2) 0 (13.3) 0 (13.4) 0 14. Total each tax (add lines 11, 12, & 13) 0 0 0 1872 The We mayoxeerl yotri aleck Wale ane One elector& banking transactvn, Your bank amount may be clamed as early as the same day receVe tdlitre is ti orunco��d.vyoxcrdrake' not bereturned.Ifyourmay is iINpduea:mN ant «urxa�da3fuxis.theaaparor•nforfte�ereenmyeaed8*pay tamount direotiyfromyvrrbankaccmnt exdronkaiy. 15, Total Amount Owed t ^I Paid EFT (add all columnsby on One 14) (355) $ 1872 DR 0100 (06/18114) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261.0013 www.TexCo/oredo.com Colorado Retail Sales Tax Return Deductions and Exemptions Schedule: Colorado Account Number Period 0a+.orr ranvrrl Name Part A —Deductions 2B. Other Deductions must be itemized in the schedule below. Note: sales to other licensed dealers page 1 of form, line 2a. 1. Service sales (A1.1) 0 2. Sales to governmental agencies, religious or charitable organizations (A2-1) 0 3. Sales of gasoline (A3.1) 0 4. Sales of drugs by prescription and prosthetic devices (A4.1) 0 5. Trade-ins for taxable resale (A5-1) 0 6. Bad debts charged -off, returned goods, trade discounts and allowances where tax was paid (cash discounts are not allowed) (A6.1) 0 7. Cost of utilities, excluding tax (restaurants only (at end of year) using DR 1465 form) (Al -1) 0 8. Sales of agricultural compounds and pesticides (A8.1) 0 9. Other (explanation required) (A9.1) 27429 Total add lines 1 through 9 (enter here and on line 2b of the return) Total 27429 Part B —Exemptions 3B. Enter total State Exemptions and applicable Local Exemption on line 3b. 1. Food, including food sold through vending machines County/MTS City/LID Special District State (61.1) 0 (81.2) 0 (814) 0 (81-4) 0 2. Machinery (B2-1) 0 (B2.2) 0 (82-3) 0 (62.4) 0 3. Electricity (83-1) 0 (B3-2) 0 (83-3) 0 (B3-4) 0 4. Farm Equipment (B4-1) 0 (84-2) 0 (84-3) 0 (84-4) 5. Sales of low -emitting vehicles, etc. (e5-1) 0 (85-2) 0 (853) 0 (B5-4) 0 6. School related sales (86.1) 0 (B6-2) 0 (B6.3) 0 (86-4) 0 7. Cigarettes (B7-1) 0 (B7-2) 0 (81-3) 0 (B7-4) '-- 8. Renewable energy components (B8.1) 0 (B8.2) 0 (88-3) 0 (88.4) 0 9. Space Flight Exemption (89-1) 0 (B9.2) 0 (89.3) 0 (89.4) 0 10. Other (explanation required) (BO -1) 0 (B0-2) 0 (80.3) 0 (Bo -4) 0 11. Total (enter here and on line 3b of the return) 0 0 0 0 DR 0100 (00/05113) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261.0013 WSWL TarcCororada.corn Signed traderpennlyof perjury Inthe second degree. Colorado Retail Sales Tax Return Departmental Use Only Signature Date (tmioci YY) 10/05/16 (� 1 ig 11II4I11o11 I�ll6ll 1l94919111I SSN 1 SSN 2 FEIN 20-8480142 9 Last Name or 9USlness Name Lewis D Morales, LLC DBA Select Stay Hotel First Name Middle Initial Address 3025 8th Avenue City Evans State CO Zip 80620 0021-100 Phone (97 0) 356-2180 1. Gross Sales and Services for this siteltocatton only (Include bad debts previously deducted) o (1d) 86,271 00 Colorado Account Number 02867565-0000 Period p.wyvAtioin 09/16 - 09/16 2. Deductions (nontaxed sales): a. Sales to other licensed dealers, for resale o (2D-4) 00 Due Date (Wvoorrr) 10/20/16 LocalionlJuris Code 03-0041 b. Other deductions (from page 2) • (2b.4) 27,382 00 Mark here if this Is an Amended Return o c. Total (add lines 2a & 2b) 27,382 00 County/MTS City/LID „ : Special District State 3. Net sates: (line 1 minus line 2c) • 134)134)_ 00 (3.2) 00 23-33 - 00 13.4) 58 , 889 00 a. Sates out of taxing area • (34.1) 00 (3a•2) 00 (3a.3) 00 (3a-4) 00 .b. Exemptions (list on page 2). • (3b.1) 00 (3b•2) 00 (3b•3) 00 (3b4) O 00 00 c, Overpayment from previous return • 130-1) 00 (30-2) 00 (3e-3) 00 (30-4) 4. Net taxable sales (fine 3 minus a,b,& c) 00 00 00 58,889 00 4) Tax Rate 0.0290 1, 708 00 5. Amount of sales tax 00 00 00 (5.4) 1,708 00 00 6. Excess tax collected • (6-1) 00 (s-2) 00 (8.3) 00 00 7. Total (add lines 5 & 6) 00 00 8. a. Service fee rate b. Service fee allowed vendor (only It paid on or before duo dale) • 0.0333 (8.1) 00 (8-2) 00 (s-3) 00 (8-4) 57 00 9. Sates tax due (line 7 minus line eb) 00 00 00 1, 651 00 10. Tax on $ • (10.1) 00 (10-2) 00 (104) 00 (104) 00 11. Total tax due (add lines 9 & 10) o (11-1) 00 (11-2) 00 (11.31 00 (11.4) 1,651 (124) 00 00 12. Penalty: • (12-1) 00 (12-2) 00 (12-3) 00 (13-2) - 00 (134) 00 (13.4) 00 13, Monthly interest rate times Tine 11 .0025 • (13-1) 00 14. Total each tax (add lines 11, 12, & 13) 00 00 00 1,651 00 1be l me maxi }+ourdscu to a one rale ekc4an:cbaniing Densacren Ysgcxs �maytodeb deseatyesthe}tamedaeyyrecevedbytha =ifyour dcdre+1not baretuned.11yarduals releeddua totraArraeNa Frrls OaDeyakrRnlorRrmuarns/ootedtia pa}rreMenanl�j6anyovpsrecaaanlctecaadcary �V� 15. Total Amount Owed l�I PaldbyEFT (add atcolumns onlinel4) (355) 1, 651 .00 OR 0100 (09/05/13) COLORADO DEPARTMENT OF REVENUE Denver, CO 60261.0013 W..TbXColomdawrs 140100 29999 Colorado Retail Sales Tax Return Deductions and Exemptions Schedule: Colorado Account Number 02867565-0000 Period ( 'mr-rtwyy) 09/16-09/16 Name Lewis D Morales, LLC DBA Select Stay Hotel Part A ---Deductions 25, Other Deductions must be itemized in the schedule below. 1. ServIce sales (A1 -I) o 00 2. Sales to governmental agencies, religious or charitable organizations (A2.1) 0 00 3. Sates of gasoline (A3-1) 00 4. Sales of drugs by prescription and prosthetic devices (A4-1) 00 5. Trade -fns for taxable resale (AB -t) 00 6. Bad debts charged -off, returned goods, trade discounts and allowances where tax was paid (cash discounts are not allowed) (AB -1) 00 7, Cost of utilities, excluding tax (A7-1) 00 8. Sales of agricultural compounds and pesticides {AB -I) 00 9. Olher (explain) Rooms rented more than 30 days and misc non-taxable (A6.1) 27,382 00 Total add lines 1 through 9 (enter here and on line 2b of the return) Total 27 , 382 00 Part B --Exemptions 3B. Enter total State Exemptions and applicable Local Exemption on line 3b. 1. Food, including food sold through vending machines Countv/MTS City/LID Special District State (01.1) 00 (61.2) 00 (01.3) 00 (61.4) 00 2. Machinery X02-1) 00 (02.2) 00 (824) 00 (02.4) 00 3. Electricity (03-1) 00 (83.2) 00 (834) 00 (03-4) 00 4. Farm Equipment 5. Sales of low -emitting vehicles, etc. (64.1) 00 (04.2) 00 (044) 00 (94.4) 00 (86-4) 00 (85.2) 00 (054) 00 (864) 00 6. School related sales (B6-1) 00 (86-2) 00 (06-3) 00 (86-4) 00 7. Cigarettes (07-1) 00 {67.2) . 00 (87.3) 00 (87-4) - N/A - (68.4) 00 00 8. Renewable energy components {69-1) 00 (83.2) 00 (B8-3) 00 9. Olher (explain) (0B-1) 00 (80.2) 00 (69-3) 00 (09.4) 0 00 10. Total (enter here and on fine 34 of the return) 00 00 00 0 00 DR 0100 (09105113) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261.0013 viww.%rColoredo,com Signed under perkily of pe0uryh Ohs second degree. Colorado Retail Sales Tax Return Departmental Use Only Signature Date atiwDOryv) 11/15/16 IIIF5 ((�jjpp {� �JJ ii�� SSN 1 S8N 2 FEIN wiNg Im �llil9��li�l 1j1 ttL11100120-8480142 Last Name or Business Name Lewis D Morales, LLC DBA Select Stay Hotel First lame Middle Initial Address 3025 8th Avenue City Evans State CO Zip 80620 0021-100 Phone (970) 356-2180 1. Gross Safes and Services for this site/location only (include bad debts previously deducted) 0 (1'4) 90 , 642 00 Colorado Account Number 02867565-0000 Period trwmuv1vy) 10/16 -10/16 2. Deductions (nontaxod sales): a. Sales to other licensed dealers, for resale • (tad) 00 Due Dale wow() 11/20/16 Location/Juris Code 03-0041 b. Other deductions (from page 2) • (2b.4) 27,465 00 Mark here if this is an Amended Return e 1-1 _ c. Total (add tines 2a & 2b) 27 , 4 65 00 County/MIS City/LID _... Special District State 3.Netsafes: (line 1 minus tine 2c) • (3-1) 00 (5-.2) 00 (3-3)- 00 (3.4) 63 , 177. 00 a. Sales out of taxing area • (3a-1) 00 13a-21 00 (3a-3) 00 (3a-4) 00 b. Exemptions (Est on page 2). • (3b-1) 00 (3b-2) 00 (3b-3) 00 (3b4) 0 00 00 c. Overpayment from previous return • (30-1) 00 (30-2) 00 (3c-3) 00 . (3e-4) 4. Net taxable sales (line 3 minus a,b,& c) 00 00 00 63 , 177 00 O Tax Rate 0.0290 6. Amount of sales tax 00 00 00 1, 832 00 6. Excess tax collected • (6.1) 00 (6-2) 00 (64) 00 (6.4) 1, 832 00 00 7. Total (add lines 5 & 6) 00 00 00 9) e. a. Service fee rate 0. 0333 b. Service fee allowed vendor (only If paid on or before due dote) • 9. Sales tax due (line 7 minus line 8b) (s-1) 00 (8-Y) 00 (9-3) 00 (8.4) 61 00 00 00 00 1, 771 00 10. Tax on $ • (10-1) 00 (10.2) 00 (10-3) 00 (10.4) 00 11. Total tax due (add lines 9 & 10) • (11-1) 00 (11-2) 00 (11-3) 00 (11.4) 1, 7 71 00 00 12. Penalty: • (12-1) 00 (12.2) 00 (12.3) 00 (12-4) 13. Monthly interest rate tinges lino 11 .0025 • (13.1) 00 (13.2) 00 (13.3) 00 (13.4) 00 14. Total each tax (add linos 11, 12, & 13) 00 00 00 1, 771 00 theSI 1 conm1 yardio:l to a one fos eteclronc b.;3 a aacfat Yasba�ltaot trtlmsiHdelvedasesfijastheSamedayrecav�the Stana.aoprno, ruu,rtdio�Nti7notbo azuoarddadi ialuetsioentauiooeer.�itiads.IheDe erR parent moat dmOjfrom per bark novadedoled' 15. Total Amount Owed Paid by EFT (add all columns online 14) (355) 1,771.00 DR 0100 (09/05/13) COLORADO DEPARTMENT OF REVENUE Denver, CO 802610013 tvw .ToxCoMredacom (h�IN�lltillil�llll�lflll�f IIL�f�INllll 140900 29999 Colorado Retail Sales Tax Return Deductions and Exemptions Schedule: CotoradoAccount Number 02867565-0000 Period ,.wm-.warn) 10/16-10/16 Name Lewis D Morales, LLC ABA Select Stay Hotel Part A --Deductions 2B. Other Deductions must be Itemized in the schedule below. 1. Service sales (A1.1) 0 00 2. Sales to governmental agencies, religious or charitable organizations (A2.1) 0 00 3. Sales of gasoline (14-1) 00 4. Sales of drugs by prescription and prosthetic devices (A4.1) 00 5. Trade-ins for taxable resale (A5-1) 00 6. Bad debts charged -off, returned goods, trade discounts and allowances where tax was paid (cash discounts are not allowed) (A8.1) 00 7. Cost of utilities, excluding tax (A7-1) 00 00 8. Sales of agricultural compounds and pesticides (A8-i) 9. Other (explain) Rooms rented more than 30 days and misc non-taxable (AB -1) 27,465 00 Total add lines I through 9 (enter here and on line 2b of the return) Total 27 , 465 00 Part B --Exemptions 38. Enter total State Exemptions and apps cable Local Exemption on line 3b. 1. Food, including food sold through vending machines County/MTS CItvILID Special District State (01.1) 00 (01.2) 00 (81.3) (82.3) 00 00 (81.4) (12.4) 00 00 _ 2. Machinery (02.1) 00 (02.2) 00 3. Electricity (83.1) 00 (83.2) 00 (03-3) 00 (03.4) 00 4. Farm Equipment (84-1) 00 (04.2) 00 (04.3) 00 (84.4) 00 5. Sales of tow -emitting vehicles, etc. (05.1) 00 (08.2) 00 (esa) 00 (08-4) 00 6. School related sales (86.1) 00 (08-2) 00 (86-3) 00 (88.4) 00 7. Cigarettes (07.1) 00 (87-2) 00 (81.3) 00 (B7.4) - N/A - 00 8. Renewable energy components (88.1) _.. 00 188.2) 00 (88.3) 00 (88-4) 00 9. Other (explain) (89.1) 00 (08.2) 00 (89-3) 00 (09.4) 0 00 10. Total (enterhere and on me 3b of the return) 00 00 00 0 00 DR 0100 (09105/13) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261.0013 rvti TarCabrado.com Road under psnatys(pc yhtheseconddegree. Colorado Retail Sales Tax Return Departmental Use Only Signature Date tMM100/YY) 12ssr� I'.tlh,ll4Il(liilI0laIIII1 II IIItllillliII 1 SSN FEIN 20-8480142 14 0 19999 Last Name or Business Name Lewis D Morales, LLC DBA Select Stay Hotel First l� ame Middle Initial Address 3025 8th Avenue City Evans State CO Zip 80620 0021-100 Phone (970) 356-2180 1. Gross Sales and Services for this site/location only (include bad debts previously deducted) o (1-'1) 73 , 549 00 Colorado Account Number 02867565-0000 Period imury.,Mr/YY) 11/16 —11/16 2. Deductions (nontaxod sales): a. Sales to other licensed dealers. for resale a (2a4) 00 Due Date (►MMrooiYY) 12/20/16 Locatlon/Jur(s odder e U 03-0041 b. Other deductions (from page 2) 0 (211.4) 26, 737 00 Mark here if this Is an t- Amended Return o f 1 o. Total (add lines 2a & 2b) 26 , 737 00 County/MTS City/LID Special District State 3. Net sales: (line 1 minus line 2c) • (3-1) 00 (3.2) 00 (3.3) 00 (3.4) 46 , 812 00 a. Sales out of taxing area • (3a-1) 00 (3a-2) 00 (3a-3) 00 (3a-4) 00 b. Exemptions (list on page 2). o (311.1) 00 (3b-2) 00 (311.3) 00 (36.4) 0 00 C. Overpayment front previous return • (3c•1) 00 (3c-2) 00 (3c.3) 00 (3c-4) Q0 4. Net taxable sales (One 3 minus a,b,& c) 00 00 00 4 6 , 812 00 o Tax Rate 0. 0290 5. Amount of sales tax 00 00 00 1, 358 00 B. Excess tax collected • (6.1) 00 (8.2) 00 (6-3) 00 (6-4) 00 7. Total (add lines 5 &6) 00 00 00 1, 358 00 Q 8. a. Service fee rate 0 .0333 b. Service too allowed vendor (only if paid on or bolero due dale) • (e-11 00 18-2) 00 (e.3) 00 18.4) 45 00 9. Sales tax due (tine 7 minus line 8b) 00 00 00 1, 313 00 10. Tax on 5 • (104) 00 (10.2) 00 (10-3) 00 (10.4) 00 11, Total tax due (add lines 9 & 10) • (11-1) 00 (11-2) 00 (11-3) 00 (11.4) 1, 313 00 00 12. Penally: o (12-1) 00 (12-2) 00 (12-3) 00 (12-4) 13. Monthly interest rate times (13.1) line 11 .0025 • (13.2) 00 00 (13-3) (13.4) 00 00 14. Total each tax (add lines 11,12, & 13) 00 00 00 1, 313 00 The Slate may Sm d)stid,stIon ore &m dcdroecbantt-g vai$acF;.e tarbatteotar4may iebked4steA/estlmn�ymedey rvd� Ole 5 t `"7"o1 Db°,zr Olp tvi`Incs7 adlu to tnw4d+•Ma u�ooacdni A�ndsf, Uw payevelarnxNJlettiyhomvox bar Aram!tkdradtaty / j� 15. Total Amount Owed l ^ I Paid by EFT (add all columns on line 14) (355) 1, 313 ,00 DR 0100 (09/05113) COLORADO DEPARTMENT OF REVENUE Denver, CO 80261.0013 wenv.TexCororado.com III6IOI IIIIIffIIIVf III I11il IIII1>li II 140100 29999 Colorado Retail Sales Tax Return Deductions and Exemptions Schedule: Colorado Account Number 02867565-0000 Period pewry u ml 11/16 -11/16 Nemo Lewis D Morales, LLC DBA Select Stay Hotel Part A ---deductions 2B. Other Deductions must be itemized in the schedule below. 1. Service sales (Ai -1) 0 00 2. Sales to governmental agencies, religious or charitable organizations (A24) 0 00 3. Sales of gasoline (A3.1) 00 4. Sales of drugs by prescription and prosthetic devices (A4.1) 00 5. Trade-ins for taxable resale (A6-1) 00 6. Bad debts charged -off, returned goods, trade discounts and allowances where tax was paid (cash discounts are not allowed) (A6.1) 00 7. Cost of utilities, excluding tax (Ar-1) 00 8. Sales of agricultural compounds and pesticides (A8-1) 00 9. Other(e)plain) Rooms rented more than 30 days and misc non-taxable i (Ae-1) 26,737 00 Total add lines 1 through 9 (enter here and on line 2b of the return) Total 26, 737 00 Part B —Exemptions 3B. Enter total State Exemptions and applicable Local Exemption on line 3b. CountylMTS City/LID Special District State 1. Food, including food sold through vending machines (81-1) 00 (01.2) 00 (B1-3) 00 (014) 00 2. Machinery (82-1) 00 (02.2) 00 (824) 00 (82.4) 00 3. Electricity (83-1) 00 (83.2) 00 (03-3) 00 (83-4) 00 4. Farm Equipment (84.1) 00 (04.2) 00 (04.3) 00 (84.4) 00 5. Sales of low -emitting vehicles, etc. (05-1) 00 (05.2) 00 (06-3) 00 (86-4) 00 6. School related sales (B6-1) 00 (86.2) 00 (36.3) 00 (36.4) 00 7. Cigarettes (87.1) 00 (07 z) 00 (07 -3) 00 (Brat - N/A - 00 8. Renewable energy components (88.1) _.(89-1) 00 108.2) 00 (08.3) 00 (88.4) 00 9. Other (explain) 00 (89-2) 00 (88-3) 00 109.4) 0 00 10. Total (enter here and on rune 3b of the roturn) 00 __ 00 00 0 00 Lori Lovato From: Sent: To: Subject: Attachments: Lori, Christine Rouch <cerouch@propertytaxadvisor.net> Tuesday, April 24, 2018 9:39 AM Lori Lovato Petitions for Abatement R7130298 2017.pdf; R7130298 2016.pdf Attached are the petitions for abatement for R7130298 with the years broke out on separate applications per your request. Please let me know if you need anything else. Thank you. Christine Rouch Office Manager Tel. 303.368.0500 Fax. 303.368.0573 3090 S, Jamaica Court, Suite 4204, Aurora. Colorado 80014 USPUTT TA! ilflssjS TIC cleat-vat/zing go Colorado Commercial .' arty r'Pr oles/I 1 5/11/2018 Property Report Weld County PROPERTY PORTAL Property Information (970) 400-3650 Technical Support (970) 400-4357 Account: R7130298 May 11, 2018 Account Information r Account Parcel Space Type Account Tax Year Buildings 1 Actual Value Assessed Value R7130298 096120208021 1 Commercial 2018 1 3,050,000 884,500 Legal EVS SG L13-14 AMENDED SOUTHGATE SUB Subdivision Block Lot Land Economic Area SOUTHGATE SUB AM PLAT 13 EVANS OLD TOWN Property Address Property City • Zip Section Township Range 3025 8TH AVE EVANS -I 20 1 05 65 Owner(s) Account Owner Name Address R7130298 MORALES LLC LEWIS D 3025 8 806201203 THAVE EVANS, CO Document History https://propertyreport.co.weld.co.us/?account=R7130298 1/5 5/11/2018 Property Report Reception Rec Date Type Grantor Grantee Doc Fee Sale Date Sale Price 1756158 SUB SUBDIVISION SOUTHGATE AMD 0.00 0 2845962 05-04-2001 WD SIGNATURE HOSPITALITY RESOURCES INC YOO INVESTMENT INC JAMES 225.00 04-26-2000 2,250,000 3162106 03-16-2004 WD YOO INVESTMENT INC JAMES INVESTMENTS INC 230.00 03-12-2004 2,300,000 3403206 07-14-2006 WD INVESTMENTS INC KIMS MORALES LEWIS D & 320.00 07-13-2006 3,200,000 3550385 04-28-2008 AFFD MORALES LEWIS D & MORALES LEWIS D 0.00 04-25-2008 0 3690226 04-30-2010 QCN MORALES LEWIS D MORALES LEWIS D LLC 0.00 04-22-2010 0 Building Information Building 1 AccountNo Building ID Occupancy R7130298 , 1 1 Hospitality F o �° I ID Type NBHD Occupancy Complete Bedrooms Baths Rooms -I-- . 1 ✓ Commercial i 6925 Hospitality 100 0 0 61 --- • - ID Exterior Roof Cover Interior HVAC Perimeter Units Unit Type Make ^, Gable Individual Heat Pump Unit 652 0 I https:/%propertyreport.co.weld.co.us/?account=R7130298 2/5 5/11/2018 Property Report ID Square Ft Condo SF Total Basement SF Finished Basement SF Garage SF Carport SF Balcony SF Porch SF 1 25,182 0 0 0 0 0 0 0 Built As Details for Building 1 ID Built As Square Ft Year Built Stories Length Width 100 Motel 25,182 1995 2 0 0 Additional Details for Building 1 ID Detail Type Description Units 1 Add On Asphalt Fair 24,450 1 Add On Concrete Slab Average 544 1 Add On Concrete Slab Fair 3,169 1 Add On Swimming Pool 500 Valuation Information Type Code Description Actual Value Assessed Value Acres Land SqFt Improvement 2215 LODGING- IMPROVEMENTS 2 854,200 827,720 0 000 0 Land 2112 MERCHANDISING - LAND 195,800 56,780 1 800 78,320 Totals - - 3,050,000 884,500 1 800 78,320 Tax Authorities 1 https //propertyreport co weld co us/2account=R7130298 3/5 5/11/2018 Property Report P Tax Area ID District District Name Current Levy Mill 0650 0700 AIMS JUNIOR COLLEGE 6.317 0650 I 0405 EVANS CITY 3.536 0650 0534 EVANS FIRE 15.500 0650 1050 HIGH PLAINS LIBRARY 3.256 0650 0301 (NCW) NORTHERN COLORADO WATER 1.000 0650 0206 SCHOOL DIST #6-GREELEY 45.628 0650 0100 WELD COUNTY 15.800 Total I- - 91.037 Photo Sketch https://propertyreport.co.weid.co.us/?account=R7130298 4 5 5/11/2018 Property Report 1st Floor 12,842 sq ft (8)1'6" X 18' BAYS (1)1'6" X 23' BAY 14.0' MIX." L Milsl MS 'ha l L um. L.al ILO .a.L 4I.3' 4.0' l .0' 4' 61 Total Rnoms 86.0' Hot Tubb L Conc. Slab 3978.0 sq. ft. Sketch by Apex IV Mndows-,*" Lam. l '6" B' i,. \ /' • Let 241 is Express Hotel 1:30' 21J.Ii Eft 1 995 Class G Stucco 18' wh thru-wall heaticool 11. 4.0' ,7.0' 16.0' 34.0' -,S 105 .0' r .. 20 u L —L Canopy 544.0 sq. ft. 16.0' ; Building 1 Page 1 it .L a L F. I Copyright © 2018 Weld County, Colorado. All rights reserved. Privacy Policy & Disclaimer I Accessibility Information https://propertyreport.co.weld.co.us/?account=R7130298 5/5 I WELD COUNTY ONLINE MAPPING Ma � Title 832.7 0 WGS_1984_Web_Mercator_Auxi liary_Sphere .C Weld County Colorado 416.33 832.7 Feet I his map is a user generated static output from an Internet mapping site and is for reference only. Data layers that appear on this map may or may not be accurate, current, or otherwise reliable THIS MAP IS NOT TO BE USED FOR NAVIGATION Legend Parcels Highway County Boundary Notes I This map is a user generated static output from an Internet mapping site and is fot reference only. Data layers that appear on this map may or may not be accurate, current, or otherwise reliable THIS MAP IS NOT TO BE USED FOR NAVIGATION Kimberly Dewey From. Sent: To- Subject: Attachments: Good Morning Danush, Kimberly Dewey Thursday, May 17, 2018 8 50 AM 'ptadvisor@propertytaxadvisor net' Petition for Abatement or Refund of Taxes Tax Abatement Hearing Letter tif This is to advise you that the Weld County Board of Commissioners will hear your petition for abatement or refund of taxes on the property described as 3025 8th Avenue, Evans, Colorado 80620 The meeting is scheduled for Wednesday, June 20, 2018, at 9 00 a m , in the Chambers of the Board of County Commissioners of Weld County, Colorado, Weld County Administration Building, 1150 O Street, Assembly Room, Greeley, Colorado 80631 If you have any further questions or concerns, please do not hesitate to contact me Sincerely, Kim Dewey Deputy Clerk to the Board Weld County 1150 O Street Greeley, CO 80631 tel 970-400-4225 Confidentiality Notice This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited 1 May 16, 2018 CLERK TO THE BOARD PHONE (970) 400-4225 PAX (970) 336-7233 1150 O STREET PO BOX758 GREELEY, COLORADO 80632 MORALES, LEWIS D , LLC 3025 8TH AVENUE EVANS, CO 80620-1203 RE SCHEDULE NUMBER R7130298 Dear Property Owner This is to advise you that the Weld County Board of Commissioners will hear your petition for abatement or refund of taxes on the property described as 3025 8th Avenue, Evans, Colorado 80620 The meeting is scheduled for Wednesday, June 20, 2018, at 9 00 a m , in the Chambers of the Board of County Commissioners of Weld County, Colorado, Weld County Administration Building, 1150 O Street, Assembly Room, Greeley, Colorado 80631 The Assessor is recommending that the Board approve your petition You are not required to be present at this hearing, however, this is your opportunity to have your position heard, particularly if your position is opposed to the Assessor's recommendation If you intend to submit any documentation in support of your position for this heanng, all such documentation must be submitted to the Office of the Clerk to the Board and to the Weld County Assessor's Office at least seven calendar days prior to the meeting date in order for it to be considered at the scheduled hearing If you have any questions concerning this matter, please do not hesitate to contact me at (970) 400-4226 Sincerely, .e04,z,_s4 4A, Esther Geisick Clerk to the Board cc Assessor WELD COUNTY PETITION FOR ABATEMENT OR REFUND OF TAXES CERTIFICATE OF MAILING FIRST NAME Dariush LAST NAME Bozorgpour COMPANY Morales, Lewis D., LLC Property Tax ADDRESS 1 3025 8th Ave •tadviso_r • ro •ert taxadvisor._net CITY Evans STA TE CO POSTAL CODE 80620-1203 I hereby certify that I have sent a notification of hearing date letter in accordance with the notification requirements of Weld County in the United States Mail, postage prepaid First Class Mail by letter as addressed on the attached list this 17th day of May, 2018. 1 cc cc a II a a ej (iii Kim Dewey Deputy Clerk to the Board U.S. Postal ServiceTM CERTIFIED MAIL° RECEIPT Domestic Mail Only For delivery information, visit our website at www.usps.com` F F I ran Certified Mail Fee Extra Services & Fees (check box, add fee as appropriate) ❑ Return Receipt (hardcopy) $ • Return Receipt (electronic) Certified Mail Restricted Delivery O Adult Signature Required $ ❑ Adult Signature Restricted Delivery $ Postage Total Postage and Fees Postmark Here --El Sent To H Mprales, Lewis O. LLC 0 t. No., A Street and A or PD o o , . V �- oa f � City, State, ZIP+4® any CO PS Form 3800, April 2015 PSN 7530-02-000-9047 See Reverse for Instructions e c a -O a /x.013 cn 4-0 C -o ' r U :11cC C C O O -g UU� Or c . a•� �c i C 0 C +' rts=00 0.Sg)® c>=�Cr cncnCc 0 .≥ Q C) 2) I-�ccCT" U cnm-O ( in 0 CD C O t CO << UUU c Co c"i ❑❑nnonEl❑ 075 O z 0 .C) V U - 0 U (r ? .? —a50 cc aoo—— - 0 Q228 in :92 U U N -s ye 0 0 0 O O Un co > stricted Delivery 0 -c U i O SCD °, �n C - .L w ■ ai a) a _CO E o E U ctsQ r a ) U p Co L a) --C -- o o Q O ■ O a) Article Add 3 d J 9590 9402 1714 6053 4712 25 r -1 c0 m 4a) c0 o4.cti CO L a) CV CJ CI CI N a 1 a) a) CC CC U a) 0 a CO O O N O O ti U) 0 CO CO E u_ U) CLERK TO THE BOARD PHONE: (970) 400-4225 FAX: (970) 336-7233 1150 O STREET P.O. BOX 758 GREELEY, COLORADO 80632 July 2, 2018 STATE OF COLORADO DIVISION OF PROPERTY TAXATION 1313 SHERMAN STREET, ROOM 419 DENVER, CO 80203 RE: PETITION FOR ABATEMENT OR REFUND OF TAXES - MORALES, LEWIS D., LLC To Whom It May Concern: Please review the attached documents, which include the original petition, a copy of the petition, two copies of the resolution approved by the Weld County Board of Commissioners, and a copy of the back-up documentation supporting the petition. Tax Years: Parcel Number: Account Number: 2017 096120208021 R7130298 If you have any questions concerning this matter, please do not hesitate to contact me at (970) 400-4213. Sincerely, Cz-(2t-c-- 0.- RtAvvt,c__, Chloe A. Rempel Deputy Clerk to the Board 6/29/2018 FedEx Ship Manager - Print Your Label(s) IN) rn C) O N CO N a mo ZW OM Z610 9211 dOC P lnr 50 - nHl m J18111801)601uv 0 < o <co CI o' m m 0 m 8 �C m V 0 O3 W m n m 23 0 O S m 0 OS .A! W E c,) �m m m m O 0 0 0 552J2/93DFCCA5 0 0 0 O 13 O 13 Tm N O co - C)0 z7 c;,m=70 -m or -r -Q or— 0om r 2 -+ mOKG7 M. O A wW K O O U, 2i3UN3S 1118 After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning: Use only the printed original label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges, along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,misdelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees, costs, and other forms of damage whether direct, incidental,consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented loss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedEx Service Guide. https://www.fedex.com/shipping/shipmentConfirmationAction.handle?method=doContinue 1/2 6/29/2018 FedEx Ship Manager - Print Your Label(s) Shipment Receipt Address Information Ship to: DIVISION OF PROPERTY TAXATION STATE OF COLORADO 1313 SHERMAN STREET ROOM 419 DENVER, CO 80203 US 3038647777 Ship from: CHLOE REMPEL WELD COUNTY 1150 O STREET RM 166 GREELEY, CO 80631 US 9704004225 Shipment Information: Tracking no.: 772607923450 Ship date: 07/02/2018 Estimated shipping charges: 5.69 USD Package Information Pricing option: FedEx Standard Rate Service type: FedEx 2Day Package type: FedEx Envelope Number of packages: 1 Total weight: 1 LBS Declared Value: 0.00 USD Special Services: Pickup/Drop-off: Drop off package at FedEx location Billing Information: Bill transportation to: COUNTYOFWELD-483 DEPARTMENT NAME: CLERK TO THE BOARD SENDER NAME: CHLOE A. 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