Form 104x - Amended Colorado Individual Income Tax Return - 2005 Page 2

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CORRECT
NET CHANGE
ORIGINAL AMOUNT
AMOUNT
OR AS PREVIOUSLY ADJUSTED
INCREASE OR (DECREASE
)
00
00
00
22 Amount from line 22 on front of form (Net Tax) ............................ 22
00
00
00
23 Federal Adjusted Gross Income ................................................... 23
(24)
00
00
00
24 State Sales Tax Refund ................................................................ 24
(07)
00
00
00
25 Colorado income tax withheld ....................................................... 25
(03)
00
00
00
26 Estimated tax ................................................................................ 26
(65)
00
00
00
27 Child care credit from line 5 or 6, Form 104 CR ........................... 27
(81)
00
00
00
28 Gross conservation easement credit from line 8, Form 104 CR ... 28
00
00
00
29 Total of 24 through 28 ................................................................... 29
00
00
00
30 If line 29 exceeds line 22, enter your overpayment ...................... 30
00
00
00
31 If line 22 exceeds line 29, enter the amount owed ....................... 31
COMPUTE THE AMOUNT YOU OWE
00
32 Enter any decrease shown on line 30 column 3 (NET CHANGE) .............................. 32
00
33 Enter any increase shown on line 31 column 3 (NET CHANGE) ............................... 33
00
34 Additional tax due, total of lines 32 and 33 ................................................................. 34
(11)
00
35 Interest due on additional tax - see instructions ......................................................... 35
(01)
00
36 Penalty due - see instructions ..................................................................................... 36
(76)
00
37 Estimated tax penalty due - see instructions .............................................................. 37
(08)
00
38 Payment due with this return, add lines 34 through 37 ............................................... 38
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.
COMPUTE YOUR REFUND
00
39 Enter any increase shown on line 30 column 3 (NET CHANGE) ............................... 39
00
40 Enter any decrease shown on line 31 column 3 (NET CHANGE) .............................. 40
(04)
00
41 Refund claimed with this return, total of lines 39 and 40 ............................................ 41
(14)
00
42 Overpayment credited to 2006 estimated tax ............................................................. 42
(01)
00
43 Penalty reduced .......................................................................................................... 43
(76)
00
44 Estimated tax penalty reduced ................................................................................... 44
(11)
00
45 Interest allowed on refund. To be computed by Department of Revenue .................. 45
00
46 To be completed by Department of Revenue ............................................................. 46
Savings
Type:
Checking
Routing number
Account number
SIGNED UNDER PENALTY OF PERJURY IN THE SECOND DEGREE:
(Name and Telephone Number of Individual
(Date)
or Firm Preparing Return)
(Signature of Taxpayer)
(Date)
(Signature of Taxpayer's Spouse, if joint return)
(Date)
Attach an explanation of the changes to your return and, if applicable, required attachments (e.g. 104CR, 204). Part-year
residents and nonresidents attach corrected Form 104PN. If this amended return is the result of an adjustment made by the
Internal Revenue Service attach a copy of the federal revenue agent's report with supporting schedules.

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