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        Departmental Use Only
                                                 DR 0020AX (05/30/14)
                                                 COLORADO DEPARTMENT OF REVENUE
                                                 Denver CO 80261-0006 
                                                 www.TaxColorado.com
                                                 (7110)

                                                         Amended Colorado Metallic  
        *140020AX19999*                                  Minerals Severance Tax Return

Taxable Year Beginning (MM/DD/YY)                              Taxable Year End (MM/DD/YY)

Last Name or Business Name                                     First Name                     Middle Initial Colorado Account Number

Address                                                                                                         FEIN

City                                                                            State     Zip       Phone Number
                                                                                                    (          )
Foreign Country                                  Name of mining operation location as recorded with the Colorado Division of Mines

County or counties in which operation is located

If this is a final return, check this box.                                                    Round To The Nearest Dollar
                                                •

 1.  Gross income from mining operation                                                           1                               00

 2.  Specific exemption (see instructions)                                                    2                                   00

 3.  Taxable income, line 1 minus line 2. If line 2 is larger, enter zero                         3                               00

 4.  Tax on gross income 2.25% of amount on line 3                                                4                               00

  5.  Ad valorem tax               Accrual basis or               Cash basis
                                                                                                  5                               00

 6.  50% of the tax on line 4                                                                 6                                   00

 7.  Ad valorem tax credit, the smaller of lines 5 or 6                                           7                               00

 8.  Tax, line 4 minus line 7                                                                     8                               00

 9.  Impact assistance credit                                                                     9                               00

 10. Net tax, line 8 minus line 9 but not less than zero                                      10                                  00

 11.  Estimated tax and extension payments                                                      11                                00
        Stop here to let the Department calculate your refund or balance due. Otherwise, manually complete the return yourself and 
 Stop   continue with line 12.

 12.  If line 11 is larger than line 10, enter your overpayment                                 12                                00

 13. Enter the overpayment from your original return or as previously adjusted                  13                                00

 14.  If line 10 is larger than line 11, enter the amount owed                                  14                                00

 15.  Enter the amount owed from your original return or as previously adjusted                 15                                00

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*140020AX29999*

Compute The Amount You Owe

16. Line 13 minus line 12, but not less than zero 16 00

17. Line 14 minus line 15, but not less than zero 17 00

18. Additional tax due, total of lines 16 and 17 18 00

19. Interest due on additional tax 19 00

20. Penalty due 20 00

21. Estimated tax penalty due 21 00

Paid by EFT
22. Payment due with this return, add lines 18 through 21 22 $ .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.

Compute your refund

23. Line 12 minus line 13, but not less than zero 23 00

24. Line 15 minus line 14, but not less than zero 24 00

25. Refund claimed with this return, total of lines 23 and 24 25 00

Routing Number Type: Checking Savings
Direct
Deposit Account Number

26. Overpayment credited to next year's estimated tax 26 00
Reason for Amendment:

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 Taxpayer or Corporate Officer Date (MM/DD/YY)

Last Name (Person Preparing Return) First Name (Person Preparing Return) Middle Initial

Address Phone Number
( )
City State Zip

Mail To And Make Checks Payable to:
Colorado Department of Revenue
Denver, CO 80261-0006

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Instructions For
Amended Colorado Metallic Minerals Severance

Tax Return—DR 0020AX

The Amended Colorado Metallic Minerals Severance
Tax Return (DR 0020AX) is required to be used
when correcting your Colorado Metallic Minerals
Severance Tax Return (DR 0020A.)

Statute of Limitations
The statute of limitations for filing a Colorado severance Enter the routing and account numbers and account type
tax claim for refund is generally three years from the due where indicated. The routing number is 9 digits. Account
date of the original return or three years from the date of numbers can be up to 17 characters (numbers and/or
last tax payment for the year involved, whichever is later. letters). Include hyphens, but do not enter spaces or
special symbols.
Colorado Account Number
Enter your Colorado account number and your Federal We recommend that you contact your financial institution
Employer Identification Number (FEIN) in the spaces to ensure you are using the correct information and that
provided. Individuals, enter your Social Security they will honor a direct deposit. See the sample check
number. below to assist you in finding the account and routing
numbers.
Forms and Information
If you have any questions you may call the Department
at 303-238-SERV(7378) or visit the official taxation Web
site at www.TaxColorado.com for forms and information.

Lines 16 through 22 Compute the amount owed to
the state on the amended return. Any decrease in the
amount of the overpayment (line 16) or increase in the
amount owed (line 17) will indicate that an amount is
owed with the amended return. To pay the amount you The Department is not responsible for a lost refund if you
owe, write your Colorado account number or FEIN on enter the wrong account information. Any refund claim
your check. Enclose but do not attach your payment with that, for any reason, cannot be deposited into the account
DR 0020AX. specified will be issued and mailed in check form instead.

Lines 23 through 26 Compute the amount of credit Interest
available on the amended return. Any increase in the If the return is amended after the original due date of the
amount of the overpayment (line 23) or decrease in the return, interest at the applicable statutory rate will accrue
amount owed (line 24) will indicate that an overpayment on any balance of tax due until paid. Interest rates are
is available with the amended return. The overpayment published on our web site at www.TaxColorado.com
can be credited to estimated tax (line 26) for the tax year
Penalty
following the period on the amended return, or can be The penalty on any balance of tax due is $30 or 30% of
requested as a refund (line 25). the balance of tax due, whichever is greater.

To pay the amount you owe, write your Colorado account
Reason for amended return
number or FEIN on your check. Enclose but do not Attach an explanation and any documentation needed
attach your payment with DR 0020AX. to substantiate the changes reported on the amended
Direct Deposit return.
The Department can deposit your refund directly into
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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