3
DR 0173 (08/28/07) WEB
COLORADO DEPARTMENT OF REVENUE
DENVER COLORADO 80261-0013
(303) 238-SERV (7378)
RETAILER’S USE TAX RETURN
• DO NOT REPORT RTA (Rural Transportation Authority) USE TAX ON THE SAME RETURN (remittance coupon) AS
STATE AND RTD/CD/FD OR BD USE TAX. USE A SEPARATE FORM.
E A C H
E A C H
• A SEPARATE RETURN (remittance coupon) MUST BE FILED FOR E A C H
E A C H
E A C H RTA DISTRICT IN WHICH USE TAX IS
DUE. (see instructions in red on page 1)
• PENALTY AND INTEREST ARE DUE IF NOT FILED ON OR BEFORE DUE DATE.
• RETURN MUST BE FILED EVEN IF NO TAX IS DUE. USE RETAILER’S USE TAX ZEROFILE (SEE PAGE 1).
• INCLUDE ACCOUNT NUMBER ON CHECK. MAKE CHECK PAYABLE TO: COLORADO DEPARTMENT OF REVENUE.
See Form Below
DETACH FORM
ON THIS LINE
MAIL COMPLETED FORM WITH PAYMENT TO THE
COLORADO DEPARTMENT OF REVENUE, DENVER CO 80261-0013
DR 0173 (08/28/07) WEB
COLORADO DEPARTMENT OF REVENUE
RETAILER’S USE TAX RETURN
SIGNED UNDER PENALTY OF
PERJURY IN THE 2ND DEGREE. Date
Phone (
)
Signature
•
Name
1. Gross Sales and Services (include bad debts, previously deducted)
(1-6)
•
00
Due Date
2. Deductions:
A. Sales to other licensed dealers, for resale
(2-6)
17
0260-102
00
Acct
Period
B. Other deductions (from line 6 on page 4) .............
C. TOTAL (add lines 2A and 2B) ..........
RTA___________
BD
FD
CD
RTD
STATE
00
00
00
00
00
00
3. NET SALES (line 1 minus line 2C) .............
00
00
00
00
00
00
A. sales out of taxing area ...........................
00
00
00
00
00
00
B. exemptions (list on page 4) .....................
•
00
00
00
00
00
00
(4-1)
(4-2)
(4-3)
(4-4)
(4-5)
(4-6)
4. Net taxable sales (line 3 minus A & B) .............
.001
.001
.001
.0100
.029
TAX RATE
00
00
00
00
00
00
5. Amount of sales tax .....................................
•
00
00
00
00
00
00
(6-1)
(6-2)
(6-3)
(6-4)
(6-5)
(6-6)
6. Excess tax collected ....................................
00
00
00
00
00
00
7. Total (add lines 5 & 6) ..................................
.0333
.0333
.0333
.0333
.0333
NOT
8. A. Service fee rate .......................................
•
APPLICABLE
00
00
00
00
00
00
(8-2)
(8-3)
(8-4)
(8-5)
(8-6)
B. Service fee allowed vendor .....................
(only if paid on or before due date)
00
00
00
00
00
00
(9-1)
(9-2)
(9-3)
(9-4)
(9-5)
(9-6)
(100)
9. Sales Tax Due (line 7 minus line 8B) .........
00
00
00
00
00
00
(10-1)
(10-2)
(10-3)
(10-4)
(10-5)
(10-6)
(200)
10. Penalty: 0.10 times line 9 ..........................
.0066
00
00
00
00
00
00
(300)
(11-1)
(11-2)
(11-3)
(11-4)
(11-5)
(11-6)
11. Monthly prime interest rate times line 9 .........
00
00
00
00
00
00
12. Total each tax(add lines 9, 10 & 11) .........
$
Paid by EFT
(355)
00
13. Total amount remitted (make checks payable to the Colorado Department of Revenue) ...........................................
•
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.