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                                              DR 0021X (06/24/21) 
                                              COLORADO DEPARTMENT OF REVENUE 
                                              Denver CO 80261-0006 
*DO=NOT=SEND*                                 Tax.Colorado.gov

                      2021 Amended Colorado Oil and Gas Severance 
                                                    Tax Return

                                                    Instructions

The Amended Colorado Oil and Gas Severance Tax Return               How do I use Direct Deposit?
(DR 0021X) is required to be used when correcting your              The routing number must be nine digits. The account number 
Colorado Oil and Gas Severance Tax Return (DR 0021).                can be up to 17 characters (both numbers and letters). Include 
                                                                    hyphens but omit spaces and special symbols.
Statute of Limitations
The statute of limitations for filing a Colorado severance tax 
claim for refund is generally three years from the due date of the 
original return or three years from the date of last tax payment 
for the year involved, whichever is later.
Refund for Deceased Taxpayer
To request a refund for a deceased taxpayer, write “deceased” 
across the top of the return and the date of death next to the 
deceased  person’s  name.  Additionally,  you  must  sign  the 
return and write “filling as surviving spouse” or “filling as legal 
representative” by your signature.
Any person other than the surviving spouse who files a return 
and requires a refund on behalf of a deceased person must           You should contact your financial institution to ensure your 
include a copy of the death certificate and the DR 0102, Claim      deposit will be accepted and to obtain the correct routing 
for Refund for Deceased Taxpayer.                                   and account numbers. This is especially important if you 
                                                                    want your refund deposited to a savings account at a credit 
Colorado Account Number                                             union. The Department of Revenue is not responsible for 
For business accounts, enter your Colorado account number           a lost refund if you enter the wrong account information. 
and your Federal Employer Identification Number (FEIN) in the       Any refund claim that, for any reason, cannot be deposited 
spaces provided. For individuals,  enter your Social Security       into the account specified will be issued and mailed in 
number or ITIN.                                                     check form instead.
Lines 11 through 17                                                 Interest
Compute the amount owed to the state on the amended return.         If  the  return  is  amended  after  the  original  due  date  of  the 
Any decrease in the amount of the overpayment (line 11) or          return, interest at the applicable statutory rate will accrue on 
increase in the amount owed (line 12) will indicate that an         any balance of tax due until paid. Interest rates are published 
amount is owed with the amended return. To pay the amount           on our web site at Tax.Colorado.gov
you  owe,  write  your  Colorado  account  number  or  Federal 
Employer Identification Number (FEIN) on your check. Enclose        Penalty
but do not attach your payment with DR 0021X.                       The penalty on any balance of tax due is $30 or 30% of the 
                                                                    balance of tax due, whichever is greater.
Lines 18 through 21 
Compute  the  amount  of  credit  available  on  the  amended       Reason for amended return
return. Any increase in the amount of the overpayment (line         Include an explanation and any documentation, including 
18) or decrease in the amount owed (line 19) will indicate that     schedule DR 0021D, and DR 0021PD, if applicable, 
an overpayment is available with the amended return. The            needed to substantiate the changes reported on the 
overpayment can be credited to estimated tax (line 21) for the      amended return.
tax year following the period on the amended return, or can         Forms and Information
be requested as a refund (line 20).                                 If  you have any questions you  may call the  Department of 
                                                                    Revenue at  (303) 238-SERV  (7378) or see our web site at 
Direct Deposit
The department can deposit your refund directly into                Tax.Colorado.gov for forms and information.
your account at a U.S. bank or other financial institution 
(such as a mutual fund, brokerage firm, or credit union) 
in the United States.



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                                            DR 0021X (06/24/21) 
                                            COLORADO DEPARTMENT OF REVENUE 
                                            Denver CO 80261-0006 
*210021X=19999*                             Tax.Colorado.gov
                                            Page 1 of 2

       2021 Amended Colorado Oil and Gas Severance Tax Return
                                                                                                                                   (7102)
For Taxable Year (2021)                     Fiscal Tax Year Beginning (MM/21)                        Fiscal Tax Year Ending (MM/YY)

                 2021
Last Name or Business Name                                              First Name                                                 Middle Initial

                           SSN or ITIN                                  Colorado Account Number (if applicable)
Deceased                Yes

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

                           SSN or ITIN                                  FEIN (if applicable)
Deceased                Yes

Address

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

Check one:                 Cash Basis Filer                Accrual Basis Filer

Tax and Credit – Complete schedule DR 0021D first. Include the DR 0021D with this form when you file     Round to the 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, include form(s) DR 0021W                                 4               $                              00

5.  Estimated tax and extension payments                                             5               $                              00

6.  Total Prepayments, sum of lines 4 and 5                                          6               $                              00
    Stop here to let the department calculate your refund or balance due. Otherwise, manually complete the return 
Stop
    yourself and continue with line 7. 

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

8.  Enter the overpayment from your original return or as previously adjusted        8               $                              00

9.  If line 3 is larger than line 6, enter the amount owed                           9               $                              00

10. Enter the amount owed from your original return or as previously adjusted       10               $                              00



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                                                 DR 0021X (06/24/21) 
                                                 COLORADO DEPARTMENT OF REVENUE 
                                                 Denver CO 80261-0006 
*210021X=29999*                                  Page 2 of 2
                                            Compute the amount you owe

11. Line 8 minus line 7, but not less than zero                             11   $                              00

12. Line 9 minus line 10, but not less than zero                            12   $                              00

13. Additional tax due, total of lines 11 and 12                            13   $                              00

14. Interest due on additional tax                                           14  $                              00

15. Penalty due                                                              15  $                              00

16. Estimated tax penalty due                                                16  $                              00
                                                              
17. Payment due with this return, sum of lines 13 through 16   Paid by EFT   17
                                                                                 $ 
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.
                                                 Compute your refund

18. Line 7 minus line 8 but not less than zero                                18 $                              00

19. Line 10 minus line 9, but not less than zero                              19 $                              00

20. Refund claimed with this return, sum of lines 18 and 19                   20 $                              00
21. Overpayment credited to next year’s estimated tax 
    (Do not include this amount on line 20)                                   21 $                              00

                    Routing Number                                    Type:     Checking  Savings
     Direct
     Deposit        Account Number

Reason for Amendment

Last Name of person preparing return                          First Name                                        Middle Initial

Address of person preparing return                                       Phone Number

City                                                                                      State     ZIP

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)

     Mail to and make checks payable to:         Colorado Department of Revenue, Denver, CO 80261-0006






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