City and County of Denver
Denver Occupational Privilege Tax Return
Department of Finance, Treasury Division
P.O. Box 660859
Annual
Dallas, TX 75266-0859
Business Name
Account Number
Phone Number
YOU MUST FILE A RETURN EVEN IF YOU
Primary Business Location
Period End Date
HAVE DETERMINED NO TAX IS DUE
This special annual return, in lieu of your quarterly returns, is available to all individuals, sole-proprietors and
partnerships without employees liable for the tax.
* If during the course of the year your liability changes (e.g. by adding an employee or an additional partner) it is
your responsibility to notify Denver Treasury and file an amended return.
All businesses located in Denver or performing work in Denver, regardless of the length or duration, are required
to pay the minimum $4.00 Business Occupational Privilege Tax for each month even when there are no taxable
employees.
Line 1: The Amount Due is the number of active self-employed individuals, owners, or partners of the business
for each month of the year multiplied by $4.00.
For example: One (1) self-employed taxpayer for each month = 1 x 12 x $4.00 = $48.00
Line 2b: If the return is filed or paid after the due date, enter 15% of line 1 or $25.00, whichever is greater.
Line 2a: If the return is filed or paid after the due date, enter 1% of line 1 for each month or part of a month past
due.
Line 3: Add line 1, line 2a and line 2b. Enter the total. This is the total amount owed. Include a check or money
order made payable to Manager of Finance.
RETURN LOWER PORTION - DETACH HERE
DENVER OCCUPATIONAL PRIVILEGE TAX RETURN (ANNUAL)
ACCOUNT NUMBER TAX TYPE
PERIOD
DUE DATE
AMOUNT DUE
MEDIA #
Occupational Privilege Tax
000000000005
NAME:
Line 1
AMOUNT DUE:
>
PRIMARY BUSINESS LOCATION:
Line 2
Late Filing - if
a.
Penalty: $25.00
>
return is filed
b.
Interest: 1% for each
after due date -
month the return is late
Add:
>
Line 3
Total Due and Payable:
>
000000000005
Make checks payable to: Manager of Finance
SIGNATURE
TITLE
DATE
00000000000500000000005