Enlarge image | (09/18/13) 2013 Colorado Severance Tax Booklet THIS BOOKLET CONTAINS: 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 Severance Tax Forms All forms in this booklet may be photocopied. Other severance tax forms and schedules not included in this booklet can be accessed on the Web site at: www.TaxColorado.com |
Enlarge image | Page 2 taxes paid or assessed on actual oil or gas production (not General Information the tax on facilities or equipment). However, ad valorem Colorado severance tax is imposed upon nonrenewable taxes on production from “stripper wells” should not natural resources that are removed from the earth in be included in the credit. Specific instructions for this Colorado. The tax is calculated on the gross income from deduction are on the DR 0021D, Colorado Oil and Gas oil and gas and carbon dioxide production. and Carbon Dioxide Severance Tax Schedule. You should Who Must File Return DR 0021 verify that the withholding statements accurately report Anyone who receives taxable income from oil or gas the same information as shown on your division of interest produced in Colorado. If you are a producer or own a statements and revenue checks. working interest, or a royalty interest in any oil or gas Important - Partners of a General Partnership (including carbon dioxide) produced in Colorado, or if Partners of a General Partnership should attach a copy you receive royalties on Colorado oil shale, you must pay of the partnership’s DR 0021W and a schedule detailing severance tax to the State of Colorado. Severance tax their individual portion of gross income and taxes paid might be due even though you do not realize a net profit on or withheld as reported on their individual returns. your investment. A limited partnership, LLC or S Corporation must file at Filing Period the entity level. Partners, members, or shareholders do not file The Colorado severance tax filing period should match the a severance tax return to report oil and gas income received by tax year/filing period used for federal income tax purposes. the pass-through entity. A General Partnership will not file at Filing Status the entity level. Each partner, and not the general partnership, The Colorado filing status will generally match the filing is required to file a return. status from your federal income tax return. However, the Oil and gas production from “stripper wells” is exempt Colorado severance tax filing status will always be joint from severance tax. This includes oil from a well that if you are married - regardless of whether you file jointly produces 15 barrels or less of crude oil per day or gas or separately. Single or head of household filing statuses from a well that produces 90,000 cubic feet or less of gas should file a single status Colorado severance tax return. per day, for the average of all producing days during the Due Date taxable year. 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 It is not necessary to file a severance tax return if you month after the close of your taxable year. Therefore, if meet both of the following conditions: your taxable year ends on December 31, your severance 1. the total gross oil and gas withholding on form(s) tax return is due April 15 of the following year. The DR 21W for the calendar year is less than $250; and envelope must be postmarked by the due date, or the next 2. the producer has withheld sufficiently from royalty business day if the deadline falls on a Saturday, Sunday or or production payments to cover the severance tax holiday. liability. Mail Colorado severance tax returns and tax payments to: Colorado Department of Revenue Severance Withholding Denver, CO 80261-0006 Producers or first purchasers who disburse funds must withhold 1% of the gross income for each interest owner. Filing Extension This can include royalty, working interest or any other If you are unable to complete your severance tax return by interest owner. the due date and you estimate that you will owe severance The producer or first purchaser is required to send the tax, you can request a six-month extension by filing the DR 0021W, Oil and Gas Withholding Statement to interest DR 0021S on page 11. If no balance of severance tax is owners by March 1 of each year. This form lists the gross due, an extension for filing is not required. income and the amount of severance tax the producer The DR 0021S is an extension of time to file your return. It has withheld and paid to the state from your royalty or is not an extension of time to pay severance tax. production payments. If you own an interest in more than A filing extension granted by the federal government will one well or field, you should receive a separate withholding not be honored for the Colorado severance tax return. statement from each producer or first purchaser. A copy Also, any extension to file Colorado income tax returns of each withholding statement must be attached to your does not apply to the Colorado severance tax return. severance tax return (DR 0021). Amended Returns The producer or first purchaser will also list your share of To change or correct a Colorado severance tax return, you “ad valorem” taxes, if any, on the withholding statement. must file a DR 0021X. This form is available for download Ad valorem taxes are paid by the producer to local from www.TaxColorado.com – the official Taxation Web governments (cities and counties). You are allowed a credit site. against severance tax of 87.5% of your share of ad valorem |
Enlarge image | Page 3 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. • Use the correct tax year form when filing a Colorado Estimated Severance Tax Payments 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 voucher for these DR 0021 return. Both of these forms are in this booklet. tax payments is not required; the EFT transaction is the filing. Visit www.Colorado.gov/revenue/eft for more information on • Be sure to carry the correct totals from the DR 0021D how to register and file through EFT. schedule to the DR 0021 return. Individuals are not required to make estimated payments • Attach all DR 0021Ws (Oil and Gas Withholding for 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 individual DR 0021W statement and then add them. space above the tax year of the return, mark the deceased box for the appropriate person, and fill in the date of • Do not use a 1099-MISC withholding document for death. Write “Filing as surviving spouse” or “Filing as legal severance tax filing. 1099s are income tax withholding representative” after your signature, and attach the DR 0102 documents. They will not report severance tax (refunds only) and a copy of the death certificiate. 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 • Taxpayers are either on an accrual basis or a cash oil, gas or CO 2income from Colorado sources you must basis — not both. Most individuals are on a cash basis also complete and file a Colorado state income tax return. while most corporations are on an accrual basis. Visit www.TaxColorado.com to download Form 104, which can be filed electronically for free using Revenue Online. • If a return should be filed on behalf of an entity, such as partnership or limited liability company, do not try to file See the Form 104 for details. Do not claim severance tax as an individual. withholding as a tax credit on your Colorado income tax return. Corporations that expect their Colorado severance tax liability for a tax year to exceed their Colorado severance Failure To File tax credits by $5,000 or more are required to make If your severance tax account is open, or if you have estimated tax payments. severance income that is reported to the Colorado To avoid underestimation penalties, corporations must Department of Revenue and you do not file a return for the make severance tax estimated payments by the 15th day of tax period, the Department may file a return on your behalf. the month and must payments be submitted by EFT. See Exception on page 2. Any severance tax assessed will remain due and payable until you file your return or close For more information, please review FYI General 4. your account. If you are no longer doing business in the State of Colorado, you are required to close your account by filing a DR 1102, Account Change or Closure Form. |
Enlarge image | Colorado Severance Tax Page 4 DR 0021 Instructions Line 4 Severance Tax Withheld Enter the total amount shown on all of your oil and Who Must File gas withholding statements (DR 0021W) as Colorado Every individual, corporation, business trust, limited severance tax withheld. Add all amounts, then round to the partnership, LLC, partner in a general partnership, nearest dollar. Be sure to attach your DR 0021W forms association, estate, trust or any other legal entity that to your return; missing DR 0021Ws will delay your refund. received income from oil and gas produced in Colorado Do not claim credit for conservation tax or ad valorem must file a severance tax return. The return must be taxes on this line. made for the same tax year used for federal income tax Line 5 Estimated Tax and Extension Payments purposes and is due on or before the 15th day of the fourth Enter on the total amount of your estimated tax and month following the end of the taxable year. See General extension payments made for the taxable year. Information section for exception. Refund or Balance Due Controlled group: corporations, family group, or other type of group Line 7 Overpayment In the case of a controlled group of corporations as defined Subtract line 3 from line 6 and enter the difference on line in section 613A of the Internal Revenue Code where more 7. The Department will send you a refund check for this than one member of the group is subject to the severance amount if your form is properly completed. tax, the tax must be jointly computed and the severance Line 8 Refund tax return must be jointly filed under the name of the Enter the amount from line 7 that you wish to have principal taxpaying corporation. DR 0021AS, available at refunded. The Department can deposit your refund www.TaxColorado.com must be attached. directly in to your account at a U.S. bank or other financial Joint Returns institution (such as a mutual fund, brokerage firm, or credit A married couple must file a joint return even if there is no union) in the United States. income reportable by one of the spouses. A family (man and/ Line 9 Refund Applied to Future Period or woman with minor children), when more than one member Enter on line 9 the amount of overpayment, if any, you wish of the family is subject to the severance tax, must compute the credited to estimated severance tax payment for next year. severance tax on one combined return filed under the parent(s) Social Security number. Note: parties to a Civil Union should Line 10 Tax You Owe refer to federal tax law to determine the correct filing status. If line 3 is more than line 6, you have additional tax to pay. Subtract line 6 from line 3 and enter the difference on Social Security or Colorado Account Number line 10. This is the amount you owe. Attach to your return Individuals must use a Social Security number as the a check or money order in this amount payable to the Colorado account number. Business entities must Colorado Department of Revenue. Be sure to write your provide the Colorado account number and the Federal Social Security number or Colorado account number Employer Identification Number (FEIN). Whether you are on your check or money order to ensure credit for an individual or a business entity, once you have been your payment. assigned a Colorado account number by the Colorado Department of Revenue, use the Colorado account number Line 11 Interest on all returns and correspondence submitted to the If the return is filed after the due date, interest at the Department. For Privacy Act Notice, see FYI General 2. current statutory rate will accrue on any balance of tax due until paid. The interest rate is 6% per year if we bill you and Tax and Credit your payment is made more than 30 days after you receive First, complete schedule DR 0021D to calculate your your bill. If you pay your tax with your return or within 30 severance tax. days of receiving a bill, the interest rate is 3% per year. Enter the amount of late filing interest on line 11. Line 1 Oil and Gas Severance Tax Enter your net tax from line 5 of schedule DR 0021D. Line 12 Penalty The penalty on any late filed return with a balance of tax Line 2 Impact Assistance Credit due is $30 or 30% of the balance of tax due, whichever is A credit against the severance tax is allowed with respect greater. Enter the amount of late filing penalty on line 12. to contributions to local government that are deemed to be necessary because of a new severance operation or the Line 13 Estimated Tax Penalty increase in production at an existing operation. The amount Corporations that underpay the estimated tax must enter of the credit must be certified by the Executive Director the penalty due from the DR 0206. of the Department of Local Affairs. Enter your impact assistance credit for the year on line 2. Be sure to sign your return! If filing a joint return, both spouses must sign. Line 3 Net Tax Subtract line 2 from line 1, and enter the difference on line To ensure proper processing, please include your account number on the return. 3. If line 2 is larger than line 1, enter zero. |
Enlarge image | Departmental Use Only DR 0021 (08/28/13) COLORADO DEPARTMENT OF REVENUE Denver CO 80261-0006 Colorado www.TaxColorado.com Severance Tax–Oil and Gas (7001) DR 0021 2013 -or- Fiscal Year Beginning (MM/DD) Ending (MM/DD/YY) *130021==19999* , 2013 Last Name (or Corporation Name) First Name Middle Initial Date Deceased (MM/DD/YY) SSN Colorado Account Number Deceased Yes Spouse Last Name (see controlled group definition) Spouse First Name Middle Initial Date Deceased (MM/DD/YY) SSN Colorado Account Number Deceased Yes Address FEIN City State ZIP Telephone ( ) 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 form Round To The 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 • Routing Number Type: Checking Savings Direct Deposit Account Number |
Enlarge image | *130021==29999* 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 • 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. 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 Telephone Number Address City State Zip |
Enlarge image | Page 7 same way on the severance tax schedule (DR 0021D). Instructions For Preparing You should include only the income received in the tax Severance Tax Schedule DR 0021D period. If you use the accrual basis (this applies to most Use the DR 0021D to calculate the amount of Colorado corporations), you must report income from all production severance tax to enter on line 1 of the DR 0021. in the tax period whether you actually received the Based on your accounting method (cash or accrual income or not, including deferred amounts if they are basis), use the amounts listed on the DR 0021W you reported on the federal income tax return. received to complete DR 0021D. If you disagree with the Reporting Ad Valorem Tax. (This information information provided by a producer/first purchaser, applies to the following examples.) you must request a corrected DR 0021W prior to completing the DR 0021D. Round all amounts to whole • 2011 — year of oil or gas production. dollars. • Dec. 2012 — ad valorem tax levy assessed on 2011 production ............................$1,000 Column (A) Producer Name. Enter in column (A) the name of • April 2013 — ad valorem tax the producer/first purchaser from each DR 0021W. All paid on 2011 production ....................................$1,000 information entered on form DR 0021D must have a • Ad valorem tax related to 2011 form DR 0021W included with the return. production from stripper wells ...............................$250 (B) Gross Income. Enter in column (B) the gross income Cash-Basis Taxpayers as reported on DR 0021W. This is your share of Report only ad valorem tax (on production) actually paid the gross income received or accrued on oil or gas to the county assessor during the severance tax year. production. Payments to operators of wells do not qualify, only actual (C) Gross Income Attributable To Stripper Well payments to the assessor. If a payment is skipped during Production. Enter in column (C) the gross income a tax year, (for example, delinquent) no claim for tax is attributable to stripper well production as reported on allowed. Catch-up or double payments must all be claimed the DR 0021W. in the year paid and cannot be carried back or forward. (D) Net Gross Income. Enter in column (D) the net Example 1. Taxpayer files a severance tax return for the gross income by subtracting the stripper well gross calendar year 2011 or fiscal year ending in 2011 based income listed in column (C) from the gross income upon information given above. listed in column (B). Result: Taxpayer cannot claim ad valorem tax on 2011 (E) Ad Valorem Tax.Enter in column (E) the ad valorem return since the tax was not paid in the taxpayer’s tax year. tax as reported on the DR 0021W. This is the amount Example 2. Taxpayer files a severance tax return for the paid or accrued to Colorado local governments in calendar year 2013 or fiscal year ending April or later in the taxable year on oil and gas production. Do not 2013. include ad valorem tax on buildings, improvements, Result: Since the tax was paid in the tax year, 2013, or equipment. A percentage of ad valorem tax is taxpayer may report ad valorem tax of $750. allowed as a reduction to the severance tax. Calculation: (F) Ad Valorem Tax Attributable To Stripper Well Ad valorem tax paid in tax year $1,000 Production. Enter in column (F) the ad valorem tax attributable to stripper well production as reported on Less ad valorem tax related to stripper-well the DR 0021W. production ($250) (G) Net Ad Valorem Tax. Enter in column (G) the net Total ad valorem tax reported on ad valorem tax by subtracting the stripper well ad 2013 return $750 valorem tax listed in column (F) from the ad valorem Accrual Basis Taxpayers tax listed in column (E). Report only ad valorem tax (on production) levied, or assessed, within the severance tax year. In November **Note** Reporting revenue and ad valorem taxes in or December, depending upon the year, the Colorado the correct tax year is critical to filing a correct return. counties set the mill levy for assessment of ad valorem tax Please review the following information. on the prior year’s oil and gas production. The ad valorem tax is not accruable until the amount is established on Cash or Accrual Basis. Oil and gas revenue and related that date. ad valorem tax must be reported on a basis consistent with the basis used for filing your federal income tax Example 3. Taxpayer files an accrual basis severance tax return. Thus, if you are a cash-basis federal taxpayer return for calendar year 2012. (this applies to most individuals), reporting income when Result: Since the levy/assessment date is in the tax year, received and deductions when paid, you must report the 2012, taxpayer may report ad valorem tax of $750. |
Enlarge image | Page 8 Calculation: Line 1 Net Gross Income Ad valorem tax assessed in tax year $1,000 Total all amounts in column (D). Less ad valorem tax related to stripper-well Line 2 Tax Production ($250) Compute the tax on the income on line 1 using the tax rate Total ad valorem tax reported on schedule. In the case of a controlled group of corporations 2012 return $750 as defined in section 613A of the Internal Revenue Code or Example 4. Taxpayer files an accrual basis severance tax a family consisting of a man, woman and/or their minor children, where more than one member of the group return for calendar year 2013. or family is subject to the severance tax, the tax must be Result: Taxpayer cannot claim any ad valorem tax on this jointly determined and filed. In the case of a controlled return since the accrual date is not within the tax year. group of corporations, attach the DR 0021AS (Affiliation (Taxpayer could report the ad valorem tax assessed on Schedule) to the return. a fiscal year 2013 return that includes the levy date. An example would be July 2012–June 2013 fiscal year.) Line 3 Net Ad Valorem Tax Total of net ad valorem taxes entered in column (G). Check Short Period Returns whether your accounting method is on a cash-basis or Because severance tax requires filing periods consistent accrual basis [See instructions for column (E).] with federal income tax filing years, some companies may have to file short period severance tax returns to match Line 4 Ad Valorem Tax Credit their federal filings. The same ad valorem rules apply. If no Enter 87.5% of line 3. payment (cash -basis) or accrual date (accrual basis) falls Line 5 Net Tax on Oil and Gas Income within the short tax period, no claim for ad valorem tax is Enter the difference of line 2 less line 4. (If line 4 is larger, allowed. (Also, if the levy or payment date does fall in the enter 0.) Enter here and on line 1 of the DR 0021. short period, all the tax applies to only that short period.) Make sure you carry the correct totals from the DR Example 5. A cash basis taxpayer files a severance tax 0021D to the DR 0021. Please check your math. return for the short period of August 2012– December 2012. To expedite the processing of your severance tax Result: Taxpayer cannot claim any ad valorem tax; the tax return, attach all documentation to support ad valorem payment date is not within the short filing period. taxes, gross income and severance tax withheld. Example 6. An accrual basis taxpayer files a severance Mail your severance tax return and payment, if any, return for the short period of August 2012–December 2012. separately from your Colorado income tax return or any Result: Since the accrual date is within the short period, other tax return. taxpayer may claim all ad valorem tax of $750. Calculation: Ad valorem tax assessed in tax year $1,000 Less ad valorem tax related to stripper-well production ($250) Total ad valorem tax reported on short period return $750 |
Enlarge image | DR 0021D (08/28/13) COLORADO DEPARTMENT OF REVENUE Colorado Oil And Gas *130021D=19999* Denver CO 80261-0006 www.TaxColorado.com Severance Tax Schedule (Attach to Form 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 form 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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Enlarge image | DR 0021S (08/02/13) COLORADO DEPARTMENT OF REVENUE Extension Of Time For Filing Colorado Denver CO 80261-0008 www.TaxColorado.com Oil And Gas Severance Tax Return Colorado severance tax returns are due to be filed 3½ If after the original due date of the return it is found that the months 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 payment with the DR 0021S. of time to pay the tax. If at least 90% of the net tax liability Be sure to round your payment to the nearest dollar. The is not paid by the original due date of the return, penalty amount on the check and the amount entered on the and interest will be assessed. If 90% or more of the net tax payment voucher must be the same. This will help maintain liability is paid by the original due date of the return and the accuracy in your tax account. balance is paid when the return is filed by the last day of the Submit the DR 0021S with payment to: extension period, 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. DETACH FORM ON THIS LINE Photocopy for your records. Cut here and send only the coupon below. Help us save time and your tax dollars. DR 0021S (08/28/13) (7040) COLORADO DEPARTMENT OF REVENUE 2013 Extension Payment Voucher for Colorado www.TaxColorado.com Oil and Gas Severance Tax Return Return this voucher 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 voucher. 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 IF NO PAYMENT IS DUE, DO NOT FILE THIS FORM. The State may convert your check to a one time electronic banking transaction. Your bank account may be debited as early as Amount Owed 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. *130021S=19999* (Do not write in space below) $ .00 |
Enlarge image | COLORADO DEPARTMENT OF REVENUE Denver, CO 80261-0006 www.TaxColorado.com Secure Messaging Contact Department of Revenue support staff electronically through Revenue Online. This service is secure and confidential. Visit www.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 www.TaxColorado.com 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 |