DR 0289 (10/21/22)
                                                 COLORADO DEPARTMENT OF REVENUE
                                                 Tax.Colorado.gov
*220289==19999*                                  Page 1 of 2

                                Employer Contributions to  
                      Employee 529 Qualified State Tuition Program

   The Qualified State Tuition Savings Program must be administered by CollegeInvest C.R.S. 39-22-539
An employer who contributes directly to an employee’s 529 qualified state tuition program account administered by CollegeInvest is 
allowed to claim a credit against the employer’s income taxes. 
As used in:
a. A 529 qualified state tuition program account is a state tuition program account established by CollegeInvest created in section 
   23-3.1-203, C.R.S.
b. An employer is any person doing business in the state, and an employee is any person in the employment of any employer for 
   salary or for hourly wages, whether full-time or part-time and whether temporary or permanent. 
The employer is allowed to claim a credit in an amount equal to 20% of the contribution. The maximum credit an employer may claim 
for each employee in a taxable year is $500. 
The credit is neither transferable nor refundable, but may be carried forward on the employer’s return for up to three years.
In order to claim the credit for employer contributions to more than 9 qualified employee accounts, the income tax return must be 
electronically filed. 
If the return cannot be filed electronically, you may submit one 1st page of form DR 0289 with multiple 2nd pages along with the 
paper return.
Note - If all of the tax credits for each employee do not sum up correctly to the total, the return may be adjusted and credits reduced 
or denied.
 Employer/Contributor Last Name                   First Name                                       Middle Initial  FEIN/SSN/ITIN

 Employer/Contributor Address                                           City                       State           ZIP

                                                                                Available                              Used

1. Carryforward available from prior year 

2. Current year credit available, the sum of all employer tax credits generated 

3. Total credit available to be used in the current year, sum of lines 1 and 2
4.   Credit used to offset current year tax liability, enter here and on the 
   appropriate form and line number indicated in the table below. 
5. Carryforward credit to next tax year, line 3 minus line 4

By claiming this credit, I declare that to the best of my knowledge and belief, this form is true, correct, and complete.
Signature                                                                                                         Date (MM/DD/YY)

   Form                       Form Title         Line              Form                           Form Title                      Line
                                                                                Colorado Pass-Through Entity
DR 0104CR             Individual Credit Schedule 45A             DR 0106CR                                                        25A
                                                                                Credit Schedule
DR 0105               Schedule G (DR 0105)       9A              DR 0112CR      Credit Schedule for Corporations                  25A

                                         DR 0289 (10/21/22)
                                         COLORADO DEPARTMENT OF REVENUE
                                         Tax.Colorado.gov
*220289==29999*                          Page 2 of 2
  Employee/Account Owner Last Name                              First Name                                 Middle Initial
A

  SSN or ITIN                       Filing Period (DD/MM/YYYY)                     Amount of Contribution  Tax Credit*

  Employee/Account Owner Last Name                              First Name                                 Middle Initial
B

  SSN or ITIN                       Filing Period (DD/MM/YYYY)                     Amount of Contribution  Tax Credit*

  Employee/Account Owner Last Name                              First Name                                 Middle Initial
C

  SSN or ITIN                       Filing Period (DD/MM/YYYY)                     Amount of Contribution  Tax Credit*

  Employee/Account Owner Last Name                              First Name                                 Middle Initial
D

  SSN or ITIN                       Filing Period (DD/MM/YYYY)                     Amount of Contribution  Tax Credit*

  Employee/Account Owner Last Name                              First Name                                 Middle Initial
E

  SSN or ITIN                       Filing Period (DD/MM/YYYY)                     Amount of Contribution  Tax Credit*

  Employee/Account Owner Last Name                              First Name                                 Middle Initial
F

  SSN or ITIN                       Filing Period (DD/MM/YYYY)                     Amount of Contribution  Tax Credit*

  Employee/Account Owner Last Name                              First Name                                 Middle Initial
G

  SSN or ITIN                       Filing Period (DD/MM/YYYY)                     Amount of Contribution  Tax Credit*

  Employee/Account Owner Last Name                              First Name                                 Middle Initial
H

  SSN or ITIN                       Filing Period (DD/MM/YYYY)                     Amount of Contribution  Tax Credit*

  Employee/Account Owner Last Name                              First Name                                 Middle Initial
I

  SSN or ITIN                       Filing Period (DD/MM/YYYY)                     Amount of Contribution  Tax Credit*

                                   * (20% of the Value of Contribution up to $500)