Form 104 Colorado Individual Income Tax Return 2005 Page 2
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2.00
22 Amount from line 22 on front of form (Net Tax) .................................................................... 22
23 Enter the amount from federal Form 1040, line 37; or from federal Form 1040A, line 21; or
.00
from federal Form 1040EZ, line 4 (Federal Adjusted Gross Income). ................................. 23
24 STATE SALES TAX REFUND For full-year Colorado residents age 18 or older for all of
2005 or full-year residents under 18 who are otherwise qualified. Return must be filed by April
17, 2006 to claim this credit. (See instructions on page 8 if filing under extension or if under 18.)
Single Filers Enter
$15
Joint Filers Enter
$30
............................................................................................................................................. 24
.00
.00
25 COLORADO INCOME TAX WITHHELD from wages and winnings ............................... 25
26 ESTIMATED TAX payments and credits; extension payments; and amounts
.00
withheld on nonresident real estate sales and partnership/S corp/fiduciary income ........... 26
.00
27 Child care credit from line 5 or 6, Form 104CR ................................................................... 27
.00
28 Gross conservation easement credit from line 8 Form 104CR ............................................ 28
.00
29 Total of lines 24 through 28 .................................................................................................. 29
30 If line 29 is more than line 22, subtract line 22 from line 29. This is your overpayment .. 30
.00
31 Amount you want credited to your 2006 estimated tax ........................................................ 31
.00
ENTER THE AMOUNT, IF ANY, YOU WISH TO CONTRIBUTE TO:
.00
32 The Colorado Nongame and Endangered Wildlife Fund ..................................................... 32
.00
33 The Colorado Domestic Abuse Fund .................................................................................. 33
.00
34 The Colorado Homeless Prevention Activities Fund ........................................................... 34
.00
35 The Special Olympics Colorado Fund ................................................................................. 35
.00
36 The Western Colorado State Veterans Cemetery Fund ...................................................... 36
.00
37 The Pet Overpopulation Fund ............................................................................................. 37
.00
38 The Colorado Watershed Protection Fund .......................................................................... 38
.00
39 The Family Resource Centers Fund .................................................................................... 39
.00
40 The Colorado State Fair Authority Cash Fund .................................................................... 40
.00
41 The Organ and Tissue Donation Awareness Fund ............................................................. 41
.00
42 The Alzheimer’s Association Fund ...................................................................................... 42
.00
43 The Dropout Prevention Activity Grant Fund ....................................................................... 43
.00
44 The Military Family Relief Fund ........................................................................................... 44
.00
45 Total of lines 31 through 44 .................................................................................................. 45
46 Line 30 minus line 45. This is your REFUND ..................................................................... 46
.00
Type:
Savings
(See page 10)
Checking
Routing number
Account number
AMOUNT YOU OWE
.00
47 Penalty, also include on line 50 if applicable ....................................................................... 47
.00
48 Interest, also include on line 50 if applicable ....................................................................... 48
.00
49 Estimated tax penalty, also include on line 50 if applicable ................................................. 49
50 If line 22 is more than line 29, subtract line 29 from line 22. This is the amount you owe.
.00
Include amounts entered as voluntary contributions on lines 31 through 44, if any ............ 50
•
MAKE CHECK PAYABLE TO COLORADO DEPARTMENT OF REVENUE.
•
To ensure you receive credit for your payment, write your social security number and “Form 104” on your check.
•
DO NOT send cash; DO NOT staple check to return.
If your check is rejected due to insufficient or uncollected funds, the Department of Revenue may collect the payment amount directly from your
banking account electronically.
Under penalties of perjury, I declare that to the best of my knowledge and belief, this return is true, correct, and complete.
Your Signature
Date
Spouse's Signature. If joint return, BOTH must sign.
Date
➧
➧
Colorado Driver’s License or Colorado ID Number
Year of Birth
Colorado Driver’s License or Colorado ID Number
Year of Birth
Paid Preparer’s Name, Address and Telephone Number
MAIL YOUR RETURN TO:
COLORADO DEPARTMENT OF REVENUE
DENVER, CO 80261-0005
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