Departmental Use Only
DR 0278 (09/25/13)
COLORADO DEPARTMENT OF REVENUE
Denver CO 80261 - 0009
(303) 205-8205 

                  Application for Passenger  
                                   Mile Tax Account                                                          *130278==19999*

Instructions:                                                                          fourteen and which are used for transportation of passen-
This application must be completed to establish the                                    gers for compensation.
passenger mile tax account(s).
                                                                                       The Department of Revenue requires quarterly reporting.
A passenger mile account is required for all vehicles                                  Liability Date - Enter the date that the account should  
which have  passenger seating capacity of more than                                    become effective.

                                                                                                              Registration Number
Type of Ownership                     Individual             General Partnership          Corporation      

                                      Limited Partnership              Other-specify below 

If other, please specify

Taxpayer’s Last Name (owner, partners or other business organization)                  First Name                                       Middle Initial

Trade Name/Doing Business As (if applicable) Corporations, Limited Partnerships and Limited Liability Companies using their true name need not 
register for trade name.
Address of Principal Place of Business                                         City                                          State      Zip

County                                                                                                       Phone Number 
                                                                                                             (        )
Mailing Address (if different from above) (include unit no.)                   City                                          State      Zip

County                                                                                                       Phone Number 
                                                                                                             (        )
FEIN (if unavailable, SSN)                                                                                   Liability Date – see above (MM/DD/YY) 

(1) Owner/Partner Last Name                                         First Name                               Middle Initial SSN

Address (residence or P.O. Box)                                                City                                          State      Zip

(2) Owner/Partner Last Name                                         First Name                               Middle Initial SSN

Address (residence or P.O. Box)                                                City                                          State      Zip

                                                                               License Period (MM/YY-MM/YY)

      Passenger Mile Tax Account                                                                             –
License Period - The first date should be the current month and year. The second date should be December of the current year.
                                                          All accounts must file quarterly returns.
I certify, under penalty of perjury in the second degree, that the information provided on this application is true and complete to the best of 
my knowledge. (Signature required below.)
Type or Print Authorized Signature                                                                Title

Signature of Owner, Partner or Corporate Office                                                              Date (MM/DD/YY)

   Who must apply for a passenger mile tax account and issue of the license 

 Any owner or operator of a vehicle, which is operated for      A copy of the license should be carried with other  
the transportation of passengers for compensation, with a       credentials in the passenger vehicle. The original license 
seating capacity of more than fourteen passengers, must         should be retained at your place of business.
apply for an account and license.
                                                                Licenses are valid for the current calendar year. The 
 When the application is received, it will be reviewed          license will be renewed automatically on an annual basis, 
and if approved an account established for the applicant.       if the account is in good standing and taxes have been 
A license will be issued for the current calendar year.         reported and paid timely on the quarterly returns.
Review of the application, establishment of an account,  
and issuance of the license can take three to four weeks. 
You should consider this processing time to assure you 
have the proper licenses in time for hauling passengers  
in Colorado.

              Reporting and payment of the passenger mile tax account 

 Quarterly tax returns are sent to established accounts         The tax rate for the passenger mile tax is one mill per 
about a month before the due date of the return. Returns        passenger transported each mile in Colorado, ($0.001 X 
are due the last day of the month following the reporting       number of passengers X number of Colorado miles = Tax). 
quarter, for example the April-June return would be due the     Each licensee must maintain records on the number of 
31st of July.                                                   vehicles hauling passengers, the number of passengers 
                                                                hauled in Colorado, and the number of Colorado miles. 
 Non-receipt of a tax return (Form DR 0133) is not justifi-     You can order a (Form DR 7011) “Passenger Mile Detail By 
cation for not filing a return by the due date. Returns can be  Passenger Buses” by calling (303) 205-8205. The DR 7011 
downloaded at www.taxcolorado.com or by calling the Fuel        is a record form to track passengers, miles, vehicles, and 
Unit at (303) 205-8205.                                         calculate the tax. This form is not sent with the tax return.

                                      Completing the Application Form 

 • Complete the form in its entirety.                           • License period, enter the month and year passenger 
 • Check the appropriate box for the type of ownership          service is begun. (License is for current year.)
 • Provide the name of the owner, trade name, location          • The application must be signed, dated and sent. 
 address, mailing address, and multiple owners in the           • Allow three to four weeks to receive a license. If  
 spaces provided. If you need additional space for              your application is not approved you will be notified  
 owners attach a list on a separate sheet of paper.             in writing.
 • Trade names are registered with the Colorado Secretary  
 of State.