PDF document

- 1 -

Enlarge image

Departmental Use Only
DR 0461 (08/30/13)
Colorado department of revenue
Denver CO 80261-0006
www.TaxColorado.com

7022

monthly return of oil
*130461==19999*
and Gas tax Withheld
Colorado Account Number FEIN

Name

Address City State Zip

Period (MM/YY-MM/YY) Due Date (MM/DD/YY)
-
mail to and make checks payable to: Colorado Department of Revenue
Denver, CO 80261-0006

Instructions
Oil and gas withholding must be remitted electronically. (Submit this paper return only if you are reporting an amount
on line 2, 3, 4 or 5, or until your eft account is established.) Penalty and interest will apply to payments submitted
with this form if you are not actively pursuing an EFT account.
line 1: Enter the total of all Colorado oil and gas severance taxes withheld from disbursements made during the
month.
line 2: Enter the total of any underpayment adjustments for prior periods. (Attach explanation.)
line 3: Enter the total of any overpayment (not to exceed the sum of lines 1 and 2) adjustments for prior tax periods.
(Attach explanation.)
line 4: Penalty: 30% of tax or $30, whichever is greater if payment is delinquent.
line 5: Interest applies at the current rate on the total tax due from the date due until paid if the payment is
delinquent.
line 6: Enter the total. (Add lines 1, 2, 4 and 5 minus line 3.)

You must round to the nearest dollar oil and Gas

1. Total Colorado severance tax withheld 1 $ 00
Month
2. Additional tax due for prior period within calendar year 2 $ 00

3. Overpayment of tax for prior period within calendar year to be applied to current tax 3 $ 00

4. Penalty 4 $ 00

5. Interest 5 $ 00

Paid by eft
6. Total Amount Due and Payable 6 $ .00
The State may convert your check to a one time electronic banking transaction. Your bank account may be debited as early as the same day received by the State. If converted, your
check will not be returned. If your check is rejected due to insufficient or uncollected funds, the Department of Revenue may collect the payment amount directly from your bank account
electronically.
please include the account number on your check to ensure proper credit.
I hereby certify under penalty of perjury in the second degree that this return, including any accompanying schedules
and statements, is a true, correct and complete return to the best of my knowledge.
Trade Name Title Phone Number
( )
Signature of Officer or Agent Date (MM/DD/YY)

- 2 -

Enlarge image

                           oil and Gas Withholding Information

Withholding rate and monthly due dates:                      Be sure to round your payment to the nearest dollar. 
Section 39-29-111, Colorado Revised Statutes, as             The amount on the check and the amount entered on 
amended, provides that every producer or every first         the payment voucher must be the same. This will help 
purchaser of oil or gas shall withhold 1% from every         maintain accuracy in your tax account.
payment disbursed, including overriding royalties and        Interest:
working interest. Withholding is not required from payments 
to the State of Colorado or U.S. Government.                 Failure to file a return and pay the tax on or before the due 
                                                             date will result in interest at the current statutory rate from 
It is further provided that the aggregate amounts so         the due date to the date of payment.
withheld during each month shall be paid to the Department 
of Revenue by these dates:                                   penalty:

Withholding month          due date                          Failure to file a return and pay the tax on or before the 
                                                             due date will result in a penalty at the rate of 30% or $30 
January                    April 1
                                                             whichever is greater, per §39-29-115(1), C.R.S.
February                   May 1
March                      June 1                            annual reconciliation reports:
April                      July 1                            On or before April 15 following the close of the calendar 
May                        August 1                          year, all producers or first purchasers withholding 
June                       September 1                       severance tax from oil and gas during the calendar year 
                                                             must file the Annual Reconciliation of Severance Tax 
July                       October 1
                                                             Withheld from Oil and Gas Payments (DR 0456). The Oil 
August                     November 1                        and Gas Withholding Statement (DR 0021W) for each 
September                  December 1                        person from whom Colorado gross severance tax was 
October                    January 1                         withheld from oil and gas payments during the calendar 
November                   February 1                        year must be submitted with the DR 0456.
December                   March 1                           for further information call (303) 238-Serv (7378) or go 
                                                             to www.taxColorado.com
A return must be filed for each calendar month.
                                                             mail to and make checks payable to: 
The paper return may only be used to report information on 
lines 2 through 5 or if you experience a delay in receiving   Colorado Department of Revenue
your EFT authorization. Submitting payment with paper         Denver, CO 80261-0006
returns after EFT authorization is received, or not applying 
for EFT authorization, may result in penalty and/or interest 
charges on your payments.

PDF file checksum: 3467101667

(Plugin #1/9.12/13.0)