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2. CERTIFICATION OF TAX LEVIES for NON-SCHOOL Governments - Clear Creek County Colorado

   Complete the form and submit it below.

6. County Tax Entity Code*
7. DOLA LGID/SID*
9. CERTIFICATION OF TAX LEVIES for NON-SCHOOL Governments
11. TO: County Commissioners of Clear Creek County, Colorado.
13. On behalf of the*

    (taxing entity)

15. the*

    (governing body)

17. of the*

    (local government)

19. Does the taxing entity have a tax levy submission?*

    1. Yes
    2. No
21. Submitted:*
    Submitted:

    (mm/dd/yyyy)

22. for budget/fiscal year*

    (yyyy)

24. (no later than Dec. 15)

26. ***Below sections for Bonds and Contracts ONLY applicable if bond revenue or contractual obligation revenue is included in submission***

    ***Mill Levy Public Information section is a requirement if taxing entity has a tax levy submission***

    CERTIFY A SEPARATE MILL LEVY FOR EACH BOND OR CONTRACT

28. BONDS*
30. CONTRACTS*
32. Mill Levy Public Information*

34. Pursuant to 39-1-125 C.R.S.

    Counties can ask local governments to submit this form to the county by December 15th pursuant to 39-1-125 (1) (c) C.R.S.

36. Taxing Entity Information *

    (DOLA  DLG Filing Local Government Number)

40. Mill Levy #1 Information*
42. Mill Levy Name or Purpose*
43. Mill Levy Rate (Mills)*
45. Previous Year Mill Levy Rate (Mills)*
46. Previous Year Mill Levy Revenue Collected *
48. Mill Levy Maximum Without Further Voter Approval*
49. Allowable Annual Growth in Mill Levy Revenue*
51. Actual Growth in Mill Levy Revenue Over the Prior Year*
52. Is revenue from this mill levy allowed to be retained and spent as a voter-approved revenue change pursuant to section 20 (7)(b) of Article X of the State Constitution (TABOR)?*
54. Is revenue from this mill levy subject to the Statutory Property Tax (5.5%) Limit in 29-1-301 C.R.S.?*
55. Is revenue from this mill levy subject to any other limit on annual revenue growth enacted by the local government or another local government?*
57. Does the mill levy need to be adjusted or does a temporary mill levy reduction need to be used in order to collect a certain amount of revenue? If “Yes”, what is the amount?*
58. Other or additional information:*
62. Mill Levy #2 Information
64. Mill Levy Name or Purpose
65. Mill Levy Rate (Mills)
67. Previous Year Mill Levy Rate (Mills)
68. Previous Year Mill Levy Revenue Collected
70. Mill Levy Maximum Without Further Voter Approval
71. Allowable Annual Growth in Mill Levy Revenue
73. Actual Growth in Mill Levy Revenue Over the Prior Year
74. Is revenue from this mill levy allowed to be retained and spent as a voter-approved revenue change pursuant to section 20 (7)(b) of Article X of the State Constitution (TABOR)?
76. Is revenue from this mill levy subject to the Statutory Property Tax (5.5%) Limit in 29-1-301 C.R.S.?
77. Is revenue from this mill levy subject to any other limit on annual revenue growth enacted by the local government or another local government?
79. Does the mill levy need to be adjusted or does a temporary mill levy reduction need to be used in order to collect a certain amount of revenue? If “Yes”, what is the amount?
80. Other or additional information:
84. Mill Levy #3 Information
86. Mill Levy Name or Purpose
87. Mill Levy Rate (Mills)
89. Previous Year Mill Levy Rate (Mills)
90. Previous Year Mill Levy Revenue Collected
92. Mill Levy Maximum Without Further Voter Approval
93. Allowable Annual Growth in Mill Levy Revenue
95. Actual Growth in Mill Levy Revenue Over the Prior Year
96. Is revenue from this mill levy allowed to be retained and spent as a voter-approved revenue change pursuant to section 20 (7)(b) of Article X of the State Constitution (TABOR)?
98. Is revenue from this mill levy subject to the Statutory Property Tax (5.5%) Limit in 29-1-301 C.R.S.?
99. Is revenue from this mill levy subject to any other limit on annual revenue growth enacted by the local government or another local government?
101. Does the mill levy need to be adjusted or does a temporary mill levy reduction need to be used in order to collect a certain amount of revenue? If “Yes”, what is the amount?
102. Other or additional information:
106. Mill Levy #4 Information
108. Mill Levy Name or Purpose
109. Mill Levy Rate (Mills)
111. Previous Year Mill Levy Rate (Mills)
112. Previous Year Mill Levy Revenue Collected
114. Mill Levy Maximum Without Further Voter Approval
115. Allowable Annual Growth in Mill Levy Revenue
117. Actual Growth in Mill Levy Revenue Over the Prior Year
118. Is revenue from this mill levy allowed to be retained and spent as a voter-approved revenue change pursuant to section 20 (7)(b) of Article X of the State Constitution (TABOR)?
120. Is revenue from this mill levy subject to the Statutory Property Tax (5.5%) Limit in 29-1-301 C.R.S.?
121. Is revenue from this mill levy subject to any other limit on annual revenue growth enacted by the local government or another local government?
123. Does the mill levy need to be adjusted or does a temporary mill levy reduction need to be used in order to collect a certain amount of revenue? If “Yes”, what is the amount?
124. Other or additional information:
128. CONTACT INFORMATION
130. Phone Number*
131. Email*
133. Street Number*
134. Street Name*
135. Street Type*
136. Apt #
138. City*
139. State*
140. Zip*
Leave This Blank:


142. 1. Receive an email copy of this form.
143. Email address

     This field is not part of the form submission.

144. Submit

* indicates a required field