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(07/02/18)
          Booklet Includes:
                     DR 0021
                     DR 0021D
                                                                   Book
                     DR 0021S
                                                   21

                              Colorado Severance Tax Booklet

          Colorado Severance Tax Forms

          This book includes: DR 0021 
                              Oil and Gas  
                              Severance Tax Return

                              DR 0021D 
                              Oil and Gas Severance Tax 
                              Computation Schedule

                              DR 0021S 
                              Application for Extension of Time to 
                              File Colorado Severance Tax Return

          MAIL COLORADO SEVERANCE TAX RETURNS AND TAX 
          PAYMENTS TO

                     COLORADO DEPARTMENT OF REVENUE
                     Denver, CO 80261-0006

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valorem taxes are paid by the producer to local governments
General Information (cities and counties). You are allowed a credit against
Colorado severance tax is imposed upon nonrenewable severance tax of 87.5% of your share of ad valorem taxes
natural resources that are removed from the earth in paid or assessed on actual oil or gas production (not the
Colorado. The tax is calculated on the gross income from oil tax on facilities or equipment). However, ad valorem
and gas and carbon dioxide production. taxes on production from “stripper wells” should not
Who Must File Return DR 0021 be included in the credit. Specific instructions for this
Anyone who receives taxable income from oil or gas deduction are on the DR 0021D, Colorado Oil and Gas and
produced in Colorado. If you are a producer or own a working Carbon Dioxide Severance Tax Schedule. You should verify
interest, or a royalty interest in any oil or gas (including carbon that the withholding statements accurately report the same
dioxide) produced in Colorado, or if you receive royalties on information as shown on your division of interest statements
Colorado oil shale, you must pay severance tax to the State and revenue checks.
of Colorado. Severance tax might be due even though you
Important - Partners of a General Partnership
do not realize a net profit on your investment. Partners of a General Partnership should attach a copy
A limited partnership, LLC or S Corporation must file at the of the partnership’s DR 0021W and a schedule detailing
entity level. Partners, members, or shareholders do not file their individual portion of gross income and taxes paid or
a severance tax return to report oil and gas income received withheld as reported on their individual returns.
by the pass-through entity. A General Partnership will not
file at the entity level. Each partner, and not the general Filing Period
partnership, is required to file a return. The Colorado severance tax filing period should match the
tax year/filing period used for federal income tax purposes.
Oil and gas production from “stripper wells” is exempt from
severance tax. This includes oil from a well that produces Filing Status
15 barrels or less of crude oil per day or gas from a well The Colorado filing status will generally match the filing status
that produces 90,000 cubic feet or less of gas per day, for from your federal income tax return. However, the Colorado
the average of all producing days during the taxable year. severance tax filing status will always be joint if you are
Each commodity must be tested for each well to determine married - regardless of whether you file jointly or separately.
that commodity’s stripper well status. More information about Single or head of household filing statuses should file a single
stripper well withholding and filing requirements can be found status Colorado severance tax return.
at Colorado.gov/Tax by reading FYI Withholding 4 and FYI Due Date
General 4. You must complete and file the DR 0021, Colorado Oil
and Gas Severance Tax Return annually. The return (and
Exception payment, if any) are due by the 15th day of the fourth month
It is not necessary to file a severance tax return if you after the close of your taxable year. Therefore, if your taxable
meet both of the following conditions: year ends on December 31, your severance tax return is
1. the total gross oil and gas withholding on form(s) due April 15 of the following year. The envelope must be
DR 0021W for the calendar year is less than $250; postmarked by the due date, or the next business day if the
and deadline falls on a Saturday, Sunday or holiday.
2. the producer has withheld sufficiently from Mail Colorado severance tax returns and tax payments to:
royalty or production payments to cover the Colorado Department of Revenue
severance tax liability. Denver, CO 80261-0006
Filing Extension
Severance Withholding If you are unable to complete your severance tax return by
Producers or first purchasers who disburse funds must withhold
the due date and you estimate that you will owe severance
1% of the gross income for each interest owner. This can tax, you can request a six-month extension by filing the
include royalty, working interest or any other interest owner. DR 0021S on page 11. If no balance of severance tax is due,
The producer or first purchaser is required to send the an extension for filing is not required.
DR 0021W, Oil and Gas Withholding Statement to interest
The DR 0021S is an extension of time to file your return. It is
owners by March 1 of each year. This form lists the gross
not an extension of time to pay severance tax.
income and the amount of severance tax the producer has
withheld and paid to the state from your royalty or production A filing extension granted by the federal government will not
payments. If you own an interest in more than one well or be honored for the Colorado severance tax return. Also, any
field, you should receive a separate withholding statement extension to file Colorado income tax returns does not apply
from each producer or first purchaser. A copy of each to the Colorado severance tax return.
withholding statement must be attached to your severance Amended Returns
tax return (DR 0021). To change or correct a Colorado severance tax return, you
The producer or first purchaser will also list your share of must file a DR 0021X. This form is available for download
“ad valorem” taxes, if any, on the withholding statement. Ad from Colorado.gov/Tax – the official Taxation web site.

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Returns For Prior Years                                            Common Filing Errors 
Colorado severance tax returns for prior years can be filed        Be alert to the following filing tips to avoid delays in return 
at any time. However, the statute of limitations for claiming a    processing, payments and refunds.
severance tax refund is three years from the due date.
                                                                   • Indicate the correct tax or fiscal year when filing a 
Estimated Severance Tax Payments                                     Colorado severance tax return.
Corporations who expect their Colorado severance tax 
liability  for  the  year to exceed  their  Colorado severance     • Married couples must file jointly even if only one 
credits by $5,000 or more are required to make estimated             spouse has oil and gas income.
tax payments. Estimated tax payments are due each month            • Taxpayers must complete the DR 0021D, Colorado Oil 
by the 15th day of that month and    must be submitted by            and Gas Severance Tax Schedule, and attach it to the 
Electronic Funds Transfer (EFT). A paper form for these tax          DR 0021 return. Both of these forms are in this booklet.
payments is not required; the EFT transaction is the filing. Visit 
Colorado.gov/Revenue/EFT for more information on how to            • Be sure to carry the correct totals from the DR 0021D 
register and file through EFT.                                       schedule to the DR 0021 return.
Individuals are not required to make estimated payments for        • Attach all DR 0021Ws (Oil and Gas Withholding 
severance tax.                                                       Statement) to the DR 0021 return. Missing DR 0021Ws 
                                                                     result in delayed refunds.
Deceased Persons
Legal  representatives  and  surviving  spouses  may  file  a      • Add up all the DR 0021W withholding statements, 
return on behalf of a deceased person. Complete the return           then round to the nearest dollar. Do not round each 
as usual. Write “Deceased” in large letters in the white space       individual DR 0021W statement and then add them.
above the tax year of the return, mark the deceased box for 
the appropriate person, and fill in the date of death. Write       • Do not use a 1099-MISC withholding document for 
“Filing as surviving spouse” or “Filing as legal representative”     severance tax filing. 1099s are income tax withholding 
after your signature, and attach the DR 0102 (refunds only)          documents. They will not report severance tax 
and a copy of the death certificate.                                 withholding and the department will not allow credit 
                                                                     based on the withholding shown on a 1099 document.
Record Retention
Keep all documentation you used to prepare your return             • Do not try to claim a percentage of the withholding 
for at least three years after the due date or filing date of        shown on the DR 0021W and do not create 
your return, whichever is later. If your return is audited by        spreadsheets to show the ownership percentage. 
the Colorado Department of Revenue, you must be able to              Use the amounts on the DR 0021W. The ownership 
provide back-up documents for all claims and credits listed on       percentage has already been calculated by the entity 
your return. Please note that you are not protected from audit       that issued the DR 0021W withholding statement.
adjustments to your severance tax return simply because              Do not claim all of the withholding but only part of the 
                                                                   • 
an operator or purchaser supplied the information. Also, the 
                                                                     income.
Department of Revenue may request copies of your federal 
and Colorado income tax return or other documentation in           • Do not deduct gross payments attributable to stripper 
connection with your Colorado severance return.                      well production if these are not shown as stripper well 
                                                                     income on a DR 0021W.
Income Tax Filing Requirement 
Severance tax is different from income tax. If you receive oil,    • Taxpayers are either on an accrual basis or a cash 
gas or CO 2income from Colorado sources you must also                basis — not both. Most individuals are on a cash basis 
complete and file a Colorado state income tax return. Visit          while most corporations are on an accrual basis.
Colorado.gov/Tax  to download the DR 0104, which can be 
filed electronically for free using Revenue Online. See the DR     • If a return is filed on behalf of an entity such as 
                                                                     partnership or limited liability company, do not try to file 
0104 for details. Do not claim severance tax withholding 
                                                                     as an individual.
as a tax credit on your Colorado income tax return.
Failure To File                                                    • Corporations that expect their Colorado severance 
If your severance tax account is open, or if you have severance      tax liability for a tax year to exceed their Colorado 
income that is reported to the Colorado Department of                severance tax credits by $5,000 or more are required 
Revenue and you do not file a return for the tax period, the         to make estimated tax payments.
Department may file a return on your behalf. See Exception         • To avoid underestimation penalties, corporations must 
on page 2. Any severance tax assessed will remain due and            make severance tax estimated payments by the 15th 
payable until you file your return or close your account. If you     day of the month and payments must be submitted by 
are no longer doing business in the State of Colorado, you are       EFT.
required to close your account by filing the DR 1102, Account 
Change or Closure Form.                                            Please visit Colorado.gov/Tax for more information.

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DR 0021 Instructions                                             Line 4 Severance Tax Withheld
                                                                 Enter  the  total  amount  shown  on  all  of your  oil  and  gas 
Who Must File                                                    withholding statements (DR 0021W) as Colorado severance 
Every individual, corporation, business trust, limited           tax withheld. Add all amounts, then round to the nearest 
partnership, LLC, partner in a general partnership,              dollar. Be sure to attach your DR 0021W forms to your 
association, estate, trust or any other legal entity that        return; missing DR 0021Ws will delay your refund. Do not 
received income from oil and gas produced in Colorado must       claim credit for conservation tax or ad valorem taxes 
file a severance tax return. The return must be made for the     on this line.
same tax year used for federal income tax purposes and is 
                                                                 Line 5 Estimated Tax and Extension Payments
due on or before the 15th day of the fourth month following      Enter on the total amount of your estimated tax and extension 
the end of the taxable year. See General Information section     payments made for the taxable year.
for exception. If you are an oil and gas producer you must 
complete the DR 0021PD and retain for your records.              Refund or Balance Due
Controlled group: corporations, family group,                    Line 7 Overpayment
or other type of group                                           Subtract line 3 from line 6 and enter the difference on line 7. 
In the case of a controlled group of corporations as defined     The Department will send you a refund check for this amount 
in section 613A of the Internal Revenue Code where more          if your return is properly completed.
than one member of the group is subject to the severance         Line 8 Refund
tax, the tax must be jointly computed and the severance tax      Enter the amount from line 7 that you wish to have refunded. 
return must be jointly filed under the name of the principal     The Department can deposit your refund directly in to your 
taxpaying corporation. DR 0021AS, available at         Colorado. account at a U.S. bank or other financial institution (such as 
gov/Tax must be attached.                                        a mutual fund, brokerage firm, or credit union) in the United 
Joint Returns                                                    States.
When more than one member of a family is subject to the          Line 9 Refund Applied to Future Period
severance tax, they shall compute the severance tax on one       Enter on line 9 the amount of overpayment, if any, you wish 
combined return. Note: parties to a Civil Union should refer to  credited to estimated severance tax payment for next year.
federal tax law to determine the correct filing status.
                                                                 Line 10 Tax You Owe
Social Security or Colorado Account Number                       If line 3 is more than line 6, you have additional tax to pay. 
Individuals must use a Social Security number as the Colorado    Subtract line 6 from line 3 and enter the difference on line 10. 
account number. Business entities must provide the Colorado      This is the amount you owe. Attach to your return a check 
account number (CAN) and the Federal Employer Identification     or money order in this amount payable to the Colorado 
Number (FEIN). Whether you are an individual or a business       Department  of  Revenue.   Be  sure  to  write  your  Social 
entity, once you have been assigned a Colorado account           Security number or Colorado account number on your 
number by the Colorado Department of Revenue, use the            check or money order to ensure credit for your payment.
Colorado account number on all returns and correspondence 
submitted to the Department. See Colorado.gov/Tax for            Line 11 Interest
Privacy Act Notice.                                              If the return is filed after the due date, interest at the current 
                                                                 statutory rate will accrue on any balance of tax due until 
Tax and Credit                                                   paid. The interest rate is 6% per year if we bill you and your 
First, complete schedule DR  0021D to  calculate  your           payment is made more than 30 days after you receive your 
severance tax.                                                   bill. If you pay your tax with your return or within 30 days of 
                                                                 receiving a bill, the interest rate is 3% per year. Enter the 
Line 1 Oil and Gas Severance Tax                                 amount of late filing interest on line 11.
Enter your net tax from line 5 of schedule DR 0021D.
                                                                 Line 12 Penalty
Line 2 Impact Assistance Credit                                  The penalty on any late filed return with a balance of tax due 
A credit against the severance tax is allowed with respect       is $30 or 30% of the balance of tax due, whichever is greater. 
to contributions to local government that are deemed to be       Enter the amount of late filing penalty on line 12.
necessary because of a new severance operation or the 
increase in production at an existing operation. The amount      Line 13 Estimated Tax Penalty
of the credit must be certified by the Executive Director of the  Corporations that underpay the estimated tax must enter the 
Department of Local Affairs. Enter your impact assistance  penalty due from the DR 0206.
credit for the year on line 2.
                                                                 Be sure to sign your return! If filing a joint return, both 
Line 3 Net Tax                                                   parties must sign. 
Subtract line 2 from line 1, and enter the difference on line 3. 
                                                                 To ensure proper processing, please include your 
If line 2 is larger than line 1, enter zero.
                                                                 account number on the return.

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           Departmental Use Only
                                            DR 0021 (07/02/18) 
                                            COLORADO DEPARTMENT OF REVENUE 
                                            Denver, CO  80261-0006 
                                            Colorado.gov/Tax
                                            (7001)

                                                                               2018 Colorado
                                                       Severance Tax–Oil and Gas DR 0021
*180021==19999*
Tax Year Beginning (MM/DD/YY)                                           Ending (MM/DD/YY)

Last Name or Business Name                                                               First Name       Middle Initial

                              Date Deceased (MM/DD/YY)      SSN                                     Colorado Account Number
  Deceased          Yes

If Joint, Spouse or Partner Last Name (see controlled group definition)                  First Name       Middle Initial

                              Date Deceased (MM/DD/YY)                                   SSN
  Deceased          Yes

Address                                                                                             FEIN

Foreign Country                                        City                              State ZIP  Phone Number

If this is a final return check this box    Are you a producer of Colorado Oil or Gas?                Yes   No

Tax and Credit – Complete schedule DR 0021D first. Attach the DR 0021D to this                      Round To The 
                    form when you file                                                              Nearest Dollar

1. Oil and gas tax, enter amount from line 5, DR 0021D                                            1               00
                                                                                               •
2. Impact assistance credit                                                                       2               00
                                                                                               •
3. Net tax, line 1 minus line 2 but not less than zero                                           3                00
                                                       Prepayments

4. Severance tax withheld, attach form DR 0021W                                                  4                00
                                                                                               • 
5. Estimated tax and extension payments                                                           5               00
                                                                                               •
6. Total prepayments, add lines 4 and 5                                                          6                00
                                                            Refund

7. If line 6 is larger than line 3, enter your overpayment                                       7                00

8. Enter amount from line 7 you want refunded                                                    8                00
                                                                                               • 
9. Enter amount from line 7, if any, you want credited to estimated tax for next year             9               00
                                                                                               •

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                                                DR 0021 
                                                (07/02/18)       2018 Colorado
*180021==29999*
                                                Severance Tax–Oil and Gas DR 0021
 Name                                                                                 Account Number

                                 Routing Number                            Type:   Checking       Savings
        Direct
        Deposit                  Account Number

                                                   Balance Due

 10. If line 3 is larger than line 6, enter the balance due here                  10                               00

 11. Interest on balance due                                                       11                              00
                                                                                 •
 12. Penalty on balance due                                                        12                              00
                                                                                 •
 13. Estimated tax penalty (corporations only)                                     13                              00
                                                                                 •

 14. Total amount due, add lines 10, 11, 12 and 13                 Paid by EFT    14
                                                                                 • 
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.
                       Mail Your Severance Tax Return Separately From Your Income Tax Return.
                                 Attach Form DR 0021W Withholding Forms.
Mail to and make checks payable to:  Colorado Department of Revenue
                                                Denver, CO 80261-0006
Under penalty of perjury in the second degree, I declare that I have examined this return and to the best of my 
knowledge and belief it is true, correct, and complete.
Signature of Individual Taxpayer                                                             Date (MM/DD/YY)

Spouse’s Signature                                                                           Date (MM/DD/YY)

Signature of Corporate Officer                                                               Date (MM/DD/YY)

Preparer’s Last Name                            Preparer’s First Name                        Preparer’s Phone Number

Address                                                                    City             State Zip

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                                             DR 0021S (07/02/18) 
                                             COLORADO DEPARTMENT OF REVENUE                                     (7040)
                                             Denver, CO 80261-0008 
*180021S=19999*                              Colorado.gov/Tax

                        Extension Of Time For Filing Colorado  
                               Oil And Gas Severance Tax Return
Colorado severance tax returns are due to be filed by the  If after the original due date of the return it is found that the 
fifteenth day of the fourth month after the close of the tax year. amount paid is insufficient to meet the 90% requirement, 
An  automatic  six-month  extension  of  time  for  filing  the   additional payment should be made as soon as possible 
Colorado severance tax return is allowed for all taxpayers.       to reduce accumulation of penalty and interest. Make such 
However, an extension of time to file is not an extension of      payment with the DR 0021S.
time to pay the tax. If at least 90% of the net tax liability is not  Be sure to round your payment to the nearest dollar. The 
paid by the original due date of the return, penalty and interest  amount on the check and the amount entered on the payment 
will be assessed. If 90% or more of the net tax liability is paid  form must be the same. This will help maintain accuracy in 
by the original due date of the return and the balance is paid  your tax account.
when the return is filed by the last day of the extension period, Submit the DR 0021S with payment to:
only interest will be assessed.
                                                                                 Colorado Department of Revenue 
Use the DR 0021S to make a payment that must be made                             Denver, CO 80261-0008
by the original due date of the return to meet the 90% 
requirement.

                                                   Worksheet
 1.  Tentative amount of tax for the taxable year after reduction for the impact 
     assistance credit (if any)                                                                                                             $

 2.  Less: (a) Severance tax withheld                                                                                                       $

                (b) Estimated tax payments                                                                                                  $

                (c) Total (a) and (b)                                                                                                       $
 3.  Balance to be remitted with this request for extension, line 1 minus line 2 (c). 
     Enter amount of payment below. Claim credit for this payment on line 5 of the DR 0021                                                  $
                                      If no payment is due, do not file the DR 0021S.
DR 0021S (07/02/18)
Return the DR 0021S with check or money order payable to the Colorado Department of Revenue, Denver, Colorado 80261-
0008. Write your Social Security number, Colorado Account Number or Federal Employer Identification Number and DR 
0021S on your check or money order. Do not send cash. Enclose, but do not staple or attach, your payment with this form.
For tax period: (MM/YY)                                           Ending: (MM/YY)

Your Last Name                                     First Name                                                   Middle Initial              SSN

Spouse’s Last Name                                 First Name                                                   Middle Initial              Spouse’s SSN

Address                                                                                                                                     FEIN

City                                         State ZIP                           Foreign Country

If no payment is due, do not file this form.                                                                                                    Amount Owed
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.                              $

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                                                      DR 0021D (07/02/18) 
                                                      COLORADO DEPARTMENT OF REVENUE 
                                                      Denver, CO 80261-0006 
*180021D=19999*                                       Colorado.gov/Tax

                                                        Colorado Oil And Gas Severance Tax 
                                                             Schedule (Attach to the DR 0021)
For tax year beginning (MM/YY)     Ending (MM/YY)        Page               Of
                                                                                        Please round to whole dollars.

Taxpayer’s Last Name                              First Name                        Middle Initial SSN or Colorado Account Number

   (A)                         (B)                (C)            (D)                (E)            (F)          (G)
Producer Name  Gross Income Gross Income                     Net Gross              Ad Valorem     Ad Valorem   Net Ad 
List each 0021W                           Attributable       Income                             Attributable to Valorem
   on a                                   to Stripper Well (Column B-C)                            Stripper Well   (Column E-F)
Separate Line                             Production                                               Production

Check Accounting Method              cash-basis       or           accrual basis

1. Net gross income [total of column (D)]                                                       1                      00
                                                                                        • 
2. Tax on total net gross income (see tax rate schedule below)                                  2                      00
                                                                                        •
3. Net ad valorem tax [total of column (G)]                                                     3                      00
                                                                                        •
4. Ad valorem tax credit, 87.5% of the amount on line 3                                         4                      00
                                                                                        •
5. Net tax on oil and gas income, line 2 minus line 4. If line 4 is larger enter 0. 
   Enter here and on line 1 of the DR 0021.                                                     5                      00
                                                      Tax Rate Schedule
If total net gross income is:                         The tax is:
Under $25,000                                         2% of gross income
$25,000–$99,999                                       $500 plus 3% of the excess over $24,999
$100,000–$299,999                                     $2,750 plus 4% of the excess over $99,999
$300,000 and over                                     $10,750 plus 5% of the excess over $299,999

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use the accrual basis (this applies to most corporations),
Instructions For Preparing you must report income from all production in the tax period
Severance Tax Schedule DR 0021D whether you actually received the income or not, including
Use the DR 0021D to calculate the amount of Colorado deferred amounts if they are reported on the federal income
severance tax to enter on line 1 of the DR 0021. tax return.
Based on your accounting method (cash or accrual basis), Cash-Basis Taxpayers
use the amounts listed on the DR 0021W you received to Report only ad valorem tax (on production) actually paid to
complete DR 0021D. If you disagree with the information the county assessor during the severance tax year. Payments
provided by a producer/first purchaser, you must request to operators of wells do not qualify, only actual payments to
a corrected DR 0021W prior to completing the DR 0021D. the assessor. If a payment is skipped during a tax year, (for
Round all amounts to whole dollars. example, delinquent) no claim for tax is allowed. Catch-up
or double payments must all be claimed in the year paid and
Column cannot be carried back or forward.
(A) Producer Name. Enter in column (A) the name of
the producer/first purchaser from each DR 0021W. All Accrual Basis Taxpayers
information entered on form DR 0021D must have a Report only ad valorem tax (on production) levied, or
form DR 0021W included with the return. assessed, within the severance tax year. In November or
December, depending upon the year, the Colorado counties
(B) Gross Income. Enter in column (B) the gross income set the mill levy for assessment of ad valorem tax on the prior
as reported on DR 0021W. This is your share of year’s oil and gas production. The ad valorem tax is not
the gross income received or accrued on oil or gas accruable until the amount is established on that date.
production.
Short Period Returns
(C) Gross Income Attributable To Stripper Well
Because severance tax requires filing periods consistent with
Production. Enter in column (C) the gross income
federal income tax filing years, some companies may have to
attributable to stripper well production as reported on file short period severance tax returns to match their federal
the DR 0021W. filings. The same ad valorem rules apply. If no payment (cash
(D) Net Gross Income. Enter in column (D) the net -basis) or accrual date (accrual basis) falls within the short
gross income by subtracting the stripper well gross tax period, no claim for ad valorem tax is allowed. (Also, if
income listed in column (C) from the gross income the levy or payment date does fall in the short period, all the
listed in column (B). tax applies to only that short period.)
(E) Ad Valorem Tax. Enter in column (E) the ad valorem
tax as reported on the DR 0021W. This is the amount To expedite the processing of your severance tax return,
paid or accrued to Colorado local governments in attach all documentation to support ad valorem taxes,
the taxable year on oil and gas production. Do not gross income and severance tax withheld.
include ad valorem tax on buildings, improvements, Mail your severance tax return and payment, if any,
or equipment. A percentage of ad valorem tax is separately from your Colorado income tax return or any
allowed as a reduction to the severance tax. other tax return.
(F) Ad Valorem Tax Attributable To Stripper Well
Production. Enter in column (F) the ad valorem tax
attributable to stripper well production as reported on
the DR 0021W.
(G) Net Ad Valorem Tax. Enter in column (G) the net
ad valorem tax by subtracting the stripper well ad
valorem tax listed in column (F) from the ad valorem
tax listed in column (E).

**Note** Reporting revenue and ad valorem taxes in the
correct tax year is critical to filing a correct return. Please
review the following information.

Cash or Accrual Basis. Oil and gas revenue and related
ad valorem tax must be reported on a basis consistent with
the basis used for filing your federal income tax return.
Thus, if you are a cash-basis federal taxpayer (this applies
to most individuals), reporting income when received and
deductions when paid, you must report the same way
on the severance tax schedule (DR 0021D). You should
include only the income received in the tax period. If you

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COLORADO DEPARTMENT OF REVENUE
Denver, CO 80261-0006
Colorado.gov/Tax

Official State of
Colorado Publication

Secure Messaging
Contact Department of Revenue support staff electronically through Revenue Online. This service is secure and
confidential. Visit Colorado.gov/RevenueOnline to register and get started.

Call Center
Assistance 303-238-SERV (7378)
Monday–Friday 8:00 a.m.–4:30 p.m.

Service Centers
Forms and information are available Monday through Friday, 8 a.m. to 4:30 p.m.
You may find directions to each service center on our web site at Colorado.gov/Tax

Colorado Springs Grand Junction
2447 N. Union Blvd. Denver 222 S. 6th Street, Room 208
1375 Sherman Street
Pueblo Fort Collins
827 W. 4th Street, Suite A 3030 S. College Avenue

Visit Colorado.gov/Tax to find other severance tax
forms and schedules not included in this booklet.

PDF file checksum: 1573768437

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