Departmental Use Only
2005
(15)
FORM 104X
AMENDED COLORADO INDIVIDUAL INCOME TAX RETURN
Reason for amended return (check one):
Changing residency status
Changing filing status
Investment credit carryback from tax year ending ______________________________
Federal net operating loss carryback from tax year ending _______________________
Protective claim, attach explanation
Other, attach explanation
LAST NAME
FIRST NAME AND INITIAL
DECEASED
SOCIAL SECURITY NUMBER
Yourself
YES
Spouse, if joint
YES
Address
Your telephone number
(
)
City
State
ZIP Code
ROUND TO THE NEAREST DOLLAR
NET CHANGE
CORRECT
ORIGINAL AMOUNT
–
AMOUNT
“
”
OR AS PREVIOUSLY ADJUSTED
INCREASE OR (DECREASE
)
00
00
1 Federal taxable income ............................................................. 1
00
ADDITIONS TO FEDERAL TAXABLE INCOME
2 State income tax addback ......................................................... 2
00
00
00
3 Other additions, explain:
00
00
00
3
00
00
00
4 Total of lines 1 through 3 ........................................................... 4
SUBTRACTIONS FROM FEDERAL TAXABLE INCOME
00
00
5 State income tax refund ............................................................ 5
00
00
00
6 United States government interest ............................................. 6
00
00
00
00
7 Pension-annuity subtraction, taxpayer ........................................ 7
00
00
00
8 Pension-annuity subtraction, spouse .......................................... 8
00
00
00
9 Colorado source capital gain ..................................................... 9
00
00
00
10 Tuition program contribution ...................................................... 10
00
00
00
11 Other subtractions, explain: ___________________________ 11
00
00
00
12 Total of lines 5 through 11 ......................................................... 12
00
00
00
13 Colorado taxable income, line 4 minus line 12 ............................ 13
00
00
(06)
00
14 Colorado tax ............................................................................. 14
00
00
00
15 Alternative minimum tax ............................................................ 15
(17)
00
16 Recapture of prior year credits ................................................... 16
00
(34)
00
17 Total of lines 14 through 16 ....................................................... 17
00
00
00
18 Personal credits from line 41, Form 104 CR ............................... 18
00
00
(37)
00
19 Alternative fuel credits from line 44, Form 104 CR ...................... 19
00
(67)
00
00
20 Enterprise zone credits from line 18, Form 104 CR ..................... 20
00
00
(29)
00
21 Total of lines 18 through 20 ....................................................... 21
00
00
00
22 Net tax, line 17 minus line 21 .................................................. 22
00
00
00