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(12/15/22)

                         Booklet Includes:
                           Instructions
                         DR 0104PTC Application

                         Para obtener una copia de la solicitud y las instrucciones
          2021           en español, por favor visite Tax.Colorado.gov/PTC-rebate
          2022

                         104PTC

                         BOOK
                         Property Tax/Rent/Heat Rebate

                  Colorado Property Tax/Rent/Heat 
                         Rebate Filing Guide

               You might qualify for the PTC if you are:

                                                      At least 65 years old
                         A single person with         or
                         total income of less         A surviving spouse at 
                         than $16,925                 least 58 years old;
               A  
                         or
               Colorado                               or
               resident  A married couple             Disabled for  
                         with total combined          all of 2022, 
                         income of less than          regardless of age, 
                         $22,858                      and received benefits 
                                                      for the full year

                         Tax.Colorado.gov

               Read all instructions before completing the application form

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Do you qualify for the PTC Rebate?
Step 1
Did you live in Colorado from January 1–December 31, 2022? If you visit family out of state, but return to your
Colorado home, you are still a Colorado resident. Yes. Continue to STEP 2. No. You do not qualify for the PTC.
Step 2
Is your TOTAL income from all sources less than the amounts in the table below?
Single $16,925
Married (combined income) $22,858
Yes. Continue to STEP 3. No. You do not qualify for the PTC.
Step 3
As of December 31, 2022, did you meet one of the age criteria in the list below? If married, at least one person has to
meet the criteria.
• Age 65 or older, or
• A surviving spouse, age 58 or older. If you were divorced before your spouse died, you are not considered a
surviving spouse and must therefore meet one of the other age criteria, or
• A disabled person of any age who was unable to engage in any substantial gainful activity for medical
reasons. You also must have qualified for full benefits from January 1–December 31, 2022 from a bona fide
public or private plan or source, based solely on your disability.
Yes. Continue to STEP 4. No. You do not qualify for the PTC.
Step 4
Did you pay property tax, rent or heating bills during this PTC period? Yes. Continue to STEP 6. No. You do
not qualify for the PTC.
Step 5
Were you claimed as a dependant on someone else’s federal income tax return? Yes. You do not qualify for the
PTC. No. You qualify. Continue to the application.

When will my rebate be issued?
The Colorado PTC Rebate is paid on a set schedule based on when your application is processed. This payment
schedule is set and cannot be changed, except that any processing or payment dates that fall on the weekend will
instead happen on the next business day. We recommend that you file in January or early February. For faster
delivery of your rebate, we recommend that you sign up for Direct Deposit (see page 5). Please review the application/
payment chart below.
Application received, Anticipated Anticipated Number
Amount of Each
approved, and processed Direct Deposit Paper Check of Equal
Installment Payment
before Payment Dates Payment Dates Installments
March 10, 2023 April 5, 2023 April 15, 2023 1/4 of total rebate 4
June 10, 2023 July 5, 2023 July 15, 2023 1/3 of total rebate 3
September 10, 2023 October 5, 2023 October 15, 2023 1/2 of total rebate 2
December 10, 2023 January 5, 2024 January 15, 2024 Full rebate 1
December 31, 2024 10 weeks after receipt 12 weeks after receipt Full rebate 1
Do not call prior to these dates.
Example: Mary Jones mails her application on January 20, 2023, she selects Direct Deposit and her application is
received and approved before March 10, 2023. She will receive 4 equal payments, one of each being deposited in her
account by 04/05/23, 07/05/23, 10/05/23 and 01/05/24.

Deadline for filing your application
Applications for the Colorado PTC Rebate for calendar year 2022 must be filed by December 31, 2024. Applications
received after that date will be denied.

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                                                          DR 0104PTC (11/21/22)
                                                          COLORADO DEPARTMENT OF REVENUE
                                                          Denver CO 80261-0005
*220104PT19999*                                           Page 1 of 2

                                                          (1063) 

         2022 Colorado Property Tax/Rent/Heat Rebate Application
         Mark here if this application is being filed to correct a previously filed 2022 PTC application.

Last Name (yourself)                                      First Name                                                    Middle Initial

Deceased                       Date of Birth (MM/DD/YYYY)                      SSN or ITIN

         Yes

Colorado Driver License/ID Number Expiration Date (MM/DD/YYYY)                 Alternate ID

Last Name (spouse, if married)                            First Name                                                    Middle Initial

Deceased                       Date of Birth (MM/DD/YYYY)                      SSN or ITIN

         Yes

Spouse's Driver License/ID Number Expiration Date (MM/DD/YYYY)                 Alternate ID

Physical Address                                                                                         Phone Number

City                                                                                                     State       ZIP

Mailing Address (if different from physical address)                           Email Address

City                                                                                                     State       ZIP

If you did not live at the address listed above for all of 2022, you must include a list of addresses at which you lived 
during 2022 and the dates you lived at each location.
Check the first box that applies to you or your spouse/partner. If none apply, do not fill out this form because you do not qualify for this rebate.

A        Age 65 or older on December 31, 2022.

B        A widow or widower at least 58 years of age on December 31, 2022.

C        Totally disabled for all of 2022 and received payment of full benefits from Social Security, SSI or the 
         Department of Human Services based solely on such disability.

D        Totally disabled for all of 2022 and received payment of full benefits from a bona fide public or private plan 
         or source based solely on such disability. You MUST include proof of disability (see page 4 of the instruction 
         book for examples of proof).

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DR 0104PTC (11/21/22)
COLORADO DEPARTMENT OF REVENUE
Denver CO 80261-0005
*220104PT29999* Page 2 of 2
Name Account Number

List in the boxes below the TOTAL amount(s) received January through December 2022. If joint, add together the income
for both parties before listing the total. DO NOT enter your monthly amounts.
1. Enter the number of months (1-12) you received Medicare during 2022. If your
Medicare premiums were paid by Medicaid, enter 0. 1

2. Social Security, SSI and/or A.N.D. benefits 2 00

3. Colorado Old Age Pension 3 00

4. Private or VA pension payments received 4 00

5. Wages, salaries and tips 5 00

6. Interest and dividends 6 00

7. Other income, Explain 7 00
Enter your property tax, rent and heat expenses.

8. If you paid 2021 property tax in 2022, enter amount here. 8 00

9. If you paid rent, enter the total for the year here. 9 00

10. If you paid heat or fuel expenses, enter the total for the year here. 10 00
11. Are your meals included in your rent payments?

No Yes OR Only part of the year, enter amount 11 00

12. Was your heat included in your rent payments?

No Yes OR Only part of the year, enter amount 12 00

13. STATE SALES TAX REFUND
If you qualify, your state sales tax refund will be $153 if you are single, or $306 if you file jointly.
14. If you qualify, we will evaluate your eligibility for the Income Qualified Senior Housing Income Tax Credit. See Instructions

Routing Number Type: Checking Savings
Direct
Account Number
Deposit

I declare under penalty of perjury in the second degree that to the best of my knowledge and belief the information herein is true, correct and complete.
Furthermore, I authorize the Department of Revenue to contact the appropriate agencies to verify any information provided on this form and the
agencies are hereby authorized to release such information to the Department of Revenue.
Your Signature Date (MM/DD/YY) Mail to: Colorado Department of Revenue,
Denver, CO 80261-0005
Spouse/Partner Signature Date (MM/DD/YY) Prepared by

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GET CASH BACK WHEN 

YOU FILE YOUR TAXES

Tax credits and refunds  

may be available to you,  

even if you are not required to file. 

Don’t miss out! Visit GetAheadColorado.org

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RECIBA UN REEMBOLSO  

CUANDO PRESENTE SU 

DECLARACIÓN DE IMPUESTOS

Créditos fiscales y reembolsos podrían estar disponibles 

para usted, incluso si no está obligado  

a presentar una declaración. 

Visita HaciaAdelanteColorado.org

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Instructions
Apply Online
If you have received rebates for the last two years and you apply using a Social Security Number (SSN) or Individual Tax
Identification Number (ITIN), you can file this application online instead of mailing it. Visit Colorado.gov/RevenueOnline and
simply answer the questions to help guide you through the application process. Using the online application will help prevent
errors or incomplete information, which might otherwise delay your rebate. You must supply an email address to file online.
For more information, read publication FYI General 2 for Privacy Act Notice on Tax.Colorado.gov, the Taxation Division's
informational website. Enter information for the 2022 calendar year only. Combining information from other years will cause
your application to be delayed or denied.
• Names—Enter your legal name as it appears on your driver license, ID card, or other identifying document.
• Civil Unions — Parties to a Civil Union must file as married.
• Physical address — If you did not live at this address for the full year, include a list of all the places you lived
throughout this year. Be sure to include the dates you lived at each location.
• Mailing address — Be certain this is your current mailing address, otherwise you may not receive your rebate.
• Driver license or ID number and expiration date —The Department might request additional proof of Colorado
residency if your license or ID was not valid for the full year.
• Email address, if you have one.
• Confirm your eligibility by checking the appropriate box. Check only one box. If you check box D, include a copy of
your disability statement that is less than 90 days old. The statement must be provided by the agency that pays the
benefits. Veterans Administration Award letters must show the disability percentage at 50% or more.
• First-time filers must provide proof of full-year Colorado residency. If you did not hold your Colorado driver license or
ID card from January 1–December 31, 2022, you must include a copy of your lease or rental agreement.

Income
Line 1 Enter the number of months (1–12) you were covered by Medicare. If your premiums were paid by Medicaid
or if you were not on Medicare, enter 0
Lines 2-6 Enter the gross income you received for each item listed. Do not list only the taxable portion. The gross
amount should be clearly identified on the statement(s) you received from the payor. Do not include Medicare
benefits on line 2 if they were paid on your behalf by a third party
Line 7 Review the tables below and report any income you received from these sources that is not already included
on lines 2-6
You must report this income:
Aid to Families with Dependent Children (AFDC) Inheritance
Temporary Assistance for Needy Families (TANF) Life Insurance Distributions (exclude funeral expenses)
Alimony Lottery and Gambling Winnings
All Taxable Income Rental Income or Loss (exclude expenses, but not depreciation)
Capital Gains Royalties
Commissions Stock Dividends or Rights (only if reported on federal income tax return)
Disability Insurance Settlements Tier 1 & 2 Railroad Retirement
Disability Payments Veterans Benefits
Farm Income or Loss (exclude expenses, but not depreciation) Worker’s Compensation
Do not report this income:
Capital Losses or Return of Capital Home Care Allowances or Adult Foster Care Assistance
Child Support Received Income Tax Refunds
Colorado PTC Rebates Received from a prior year Veterans Service-connected Disability (permanent)
Gifts Welfare Payments Received for Dependent Children (AFDC, etc.)
Heat/Fuel Assistance such as Low-income Energy Assistance Program (LEAP)

Expenses
Line 8 Enter the total amount of property tax you paid, if any. DO NOT include any supplement/assistance that was
paid by the Senior Homestead Exemption. Include only taxes that you paid in the calendar year 2022.
Line 9 Enter the total rent you paid for January 1–December 31, 2022, if any.
Line 10 Enter the total heat/fuel expenses you paid to heat your home during 2022, if any. DO NOT include any heat/
fuel expenses that were included in your rent payment.
Line 11 Check the appropriate box to indicate whether your meals were included in your rent. If meals were included
for only part of the time you paid rent, enter how much rent was paid when your meals were included.
Line 12 Check the appropriate box to indicate whether your heat/fuel was included in your rent. If heat/fuel was included
for only part of the time you paid rent, enter how much rent was paid when your heat/fuel was included.

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Line 13 The Department of Revenue will evaluate whether you qualify for the TABOR State Sales Tax Refund. If you
qualify, the amounts added to your rebate will be $153 if you are applying single or $306 if you are applying joint.
Line 14 Income Qualified Senior Housing Income Tax Credit
The Department of Revenue will use available information to evaluate whether you qualify for an additional tax
credit. If you qualify, the amount ($1,000) will be distributed with your PTC rebate in the first installment payment.
If you are not issued this payment but believe you are eligible, please file a complete income tax return (DR 0104)
requesting the credit so the Department can evaluate your credit claim. There are a number of free and sliding
scale resources available that provide help with tax filing, including AARP and VITA locations. More information
about help filing a tax return is available at https://tax.colorado.gov/community-tax-help. You should qualify if:
● your date of birth (or your spouse’s date of birth) December 31, 1957 or earlier; and
● you qualify for a PTC rebate grant; and
● you did not receive an exemption for any property tax as allowed under section 39-3-203 of the Colorado
Revised Statutes (commonly known as the Senior Property Tax Exemption or Senior Homestead
Exemption) on your property taxes for the property tax year beginning January 1, 2022.
◦ This exemption should appear on your property tax statement from your county assessor. You may
have been approved for this exemption by applying in a prior year. This exemption is generally
allowed if one owner of a home is 65 years old as of January 1, and has occupied the home as a
primary residence for at least 10 consecutive years.

Direct Deposit
You are not required to enroll in Direct Deposit, but it is highly
recommended. For faster processing of your rebate, enter the routing
and account numbers and account type. Include hyphens, but do NOT
enter spaces or special symbols. We recommend that you contact your
financial institution to ensure you are using the correct information and
that they will honor a direct deposit. See the sample check below to
assist you in finding the account and routing numbers.

Intercepted Rebates
The Department will intercept your rebate if you owe back taxes or if you owe a balance to another Colorado government
agency. If you are filing a joint application and only one party is responsible for the unpaid debt, you may file a written claim
to Colorado Department of Revenue, Injured Spouse Desk, PO Box 17087 Denver, CO 80217-0087. Claims must include
copies of all W-2, W-2G, any 1099 and/or Third Party Query Procedure (TPQY) Benefits Planning Query Handbook (BPQY)
statements received by both parties. DO NOT include your claim with this application. It will not be processed.

Signature(s)
Sign and date your application. Failure to sign and date your application will cause delays and/or denial of your rebate.

Filers without a Social Security Number or ITIN
Individuals who do not have a Social Security Number or ITIN may still be eligible for the PTC rebate. These individuals
can access an application at https://tax.colorado.gov/alt-ID-PTC-Rebate. Do not complete the alternate application if you
have a social security number or ITIN. If you have a social security number or ITIN you must use one of those ID numbers
to apply using the application in this instruction book.

Special Circumstances
Disabled Children: Complete the following to calculate the PTC rebate for disabled children:
a) Enter the total income for the disabled child. $
b) Enter the total income for the household, including the disabled child. $
c) Divide line A by line B. Enter the result. %
Multiply the amount of property tax, rent, and/or heat/fuel expenses by the amount on line c. This is the child’s portion of
the expense.
Example: Jose is a disabled child under age 18, who received $6,000 in SSI this year. His parents do not meet the age
criteria for the PTC Rebate, but earned $8,000 from wages this year. The family pays $3,600 in rent and $300 heat/fuel
to heat the home.
a) $6,000
b) $14,000
c) 42.9%
Line 9 of Jose’s application is $1,544 ($3,600 x 0.429) and line 10 is $129 ($300 x 0.429).

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Married Persons: If you were legally married but never divorced, then you are still considered married. This is true even if
you have a legal separation. If you are married, you MUST include all information about your spouse including all income
and expenses s/he had in 2022. (Unless one spouse within a married couple resides in a nursing home/assisted living
center, see the next page for more details.)
Non-married Persons Sharing a Home: If you share a home with another adult and you share the expenses of the
home, please note the following:
Property Tax
One Owner: Only the owner of the home should enter the property tax amount on their application. If the other person
living in the home pays the owner rent, the owner must report the rent as income on line 7 and the renter can report
the rent expense on their application on line 9.
or
Joint Ownership: Each owner may enter the property tax amount they paid on their own application. The amount
should be calculated according to their ownership percentage in the property. Enter the appropriate amount on line 8
of each person’s application.
Rent and/or Heat/Fuel
Each qualified person may enter the amount of rent and/or heat/fuel expenses on lines 9 and 10 of their own application.
Example: Bob and Joe share an apartment and they split expenses. Bob pays 55% and Joe pays 45%. Their rent is
$4,800 and their heat/fuel is $400. Bob should list $2,640 on line 9 and $220 on line 10. Joe will list $2,160 on line 9 and
$180 on line 10.
Nursing Home Residents: Persons living in nursing homes or assisted living centers are NOT eligible for the PTC
Rebate unless one of the following applies:
• The applicant was in assisted living for only part of the year, and
• Before they moved into assisted living, they paid rent and/or heat/fuel. In this case, the rent rebate is based
on 20% of the rental expenses and 100% of the total income received;
or
• They paid 2021 property taxes while residing in assisted living during 2022. In this case, they may report the
full amount of property tax paid.
or
• Only one spouse within a married couple resides in a nursing home/assisted living center. The spouse who
maintains the home may file as a single person to report his/her income and expenses only.
Deceased Persons: Surviving spouses or legal representatives may file a PTC application on behalf of a deceased
person whose date of death was during the application year. Complete the application as usual. You must mark the box
next to the name of the deceased person. Write “DeceaseD” in large letters in the white space above the tax year of the
return. Write “Filing as surviving spouse” or “Filing as legal representative” after your signature. Be sure to also complete
and include form DR 0102 and a copy of the death certificate with the application.

Rebate Status
You must allow a minimum of 12 weeks to process your application. To check the status of your PTC Rebate, follow
these steps:
1. Visit Colorado.gov/RevenueOnline.
2. Click on "Request a Letter ID" in the Additional Services section. Fill in the requested information. You will
receive the Letter ID by mail in about 2 weeks.
3. After you receive the Letter ID, return to Colorado.gov/RevenueOnline.
4. Click on "Colorado Property Tax, Rent, and Heat Rebate (PTC)" in the "Where's My Refund?" section.
5. Click the down-arrow next to Account Type and select Property Tax/Rent/Heat Rebate.
6. SSN is the default setting or you can click the down arrow to select ITIN.
7. Enter your SSN or ITIN.
8. Enter your Letter ID, then click OK.
DO NOT call to check your status before April 20, 2023. Please note that the phone wait times can be very long, so we
recommend that you use the internet instead. The rebate status on the internet provides the most current information
available. Please note that our internet system is not able to provide your rebate status if you do not apply using your SSN
or ITIN. If you applied using an alternate ID, you may call the call center line if you need to check on the status of your
rebate payment.

Federal Credit and Colorado Insurance Programs
Individuals with lower income and/or those who have qualifying children may be eligible for a refund resulting from the
federal and/or state Earned Income Tax Credit (EITC), the federal Child Tax Credit, and/or low-cost health insurance
through Child Health Plan Plus (CHP+). You may obtain additional information regarding the federal EITC online at
IRS.gov or by calling Colorado United Way at 211. Additional information regarding CHP+ can be found online at
CCHP.org or by calling 1-800-359-1991.

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Please read all instructions before completing the forms. PRSRT STD
STATE OF COLORADO U.S. POSTAGE
DEPARTMENT OF REVENUE PAID
DENVER CO
PERMIT NO. 212

Official State of
Colorado Publication

Do not mail application until after January 1.
Evidence of Lawful Presence
The Colorado Property Tax/Rent/Heat (PTC) Rebate is a public benefit. Beginning July 1, 2022, under Colorado law,
individuals who are 18 years old or older and are applying for a public benefit are no longer required to establish lawful
presence in the United States. PTC applicants who have a social security number (SSN) or individual taxpayer identification
number (ITIN) must use these ID numbers to apply. Applicants who do not have an SSN or ITIN, but who otherwise qualify
for the benefit, should pre-register by completing DR 0019 Application for PTC Alternate Identification and sending the
form and required documentation to Colorado Department of Revenue, Service Center Section, PO Box 17087, Denver
CO 80217-0087. Applicants must include on the form DR 0104PTC a valid Colorado driver license number or Colorado
identification number, if available. On the form DR 0104PTC application, the following may be written in the boxes for
driver license/ID number if the applicant does not have those forms of ID:
• “Military” — U.S. military card or military dependent’s ID card
• “Coast” — U.S. Coast Guard Merchant Mariner Card
• “Tribal” — Native American Tribal Document
• “Other” — Other forms of ID are accepted. See the information below.
• “Waiver” — In some circumstances an identification waiver may be obtained.
Applicants may obtain additional information regarding Accepted Forms of Identification and the Waiver Process either
online at Tax.Colorado.gov or by phone by calling 303-238-7378. PTC applicants who do not have a Colorado driver license
or ID card number must include with their form DR 0104PTC a photo-quality color copy of any one of the other accepted
forms of identification. Documents that are business card size must be enlarged to 200% or twice their original size. Valid
driver licenses from other states will not be accepted because PTC applicants must be full-year Colorado residents. Note:
If you have already obtained a waiver from the identification requirements, you do not need to obtain another waiver. The
waiver is already on file with the Colorado Department of Revenue.
PTC applications will be denied until the required identification information is submitted.

Taxpayer Service Centers
All visits for assistance and information can be scheduled at our webpage at Tax.Colorado.gov/Visit-a-Service-Center.
Forms are available Monday through Friday, 8:00 am to 4:30 pm. For those who do not need assistance, each service
center is equipped with a secure drop box for documents.
Colorado Springs Denver Metro Grand Junction
2447 N. Union Blvd. 1881 Pierce Street, Entrance B 222 S. 6th Street, Room 208
Pueblo Lakewood, CO Fort Collins
827 W. 4th Street, Suite A 3030 S. College Avenue

Department of Revenue Phone Numbers
Taxpayer Assistance .................................................................................................................303-238-SERV (7378)
Driver License/ID Card Info ..................................................................................................................303-205-5600
TTY/TTD Service ..................................................................................................................................800-659-2656

Have you applied for LEAP?
You may be eligible to receive assistance with your heating bills through LEAP. You may also be
eligible to receive free home energy saving services like window caulking and attic insulation.
Please call toll free 1-866-HEAT-HELP for more information.

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