Form Dr 1093 - Transmittal Of State W-2s And 1099s - 2004

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DR 1093 (11/10/04)
Colorado Department of Revenue
TRANSMITTAL OF STATE W-2S AND 1099S
The form below (DR 1093) is required to be submitted by all employers who remit Colorado income withholding tax. It
must be included with the paper W-2 and 1099 forms. Accounts that file by magnetic media are not required to file the
paper W-2, nor are they required to file the DR 1093 if there is no amount listed in box 3.
For information on reporting W-2 and 1099 tax data, you may obtain FYI Withholding 6 and FYI Income 2 on our Web
site at
TaxForms, Information and E-Services
DUE DATE
On or before the last day of February, (if this date is a weekend or a holiday, the transmitted form will be due the first
business day following the due date) following the end of the calendar year, or
Thirty (30) days after closure date of business.
Filing of W-2s - All withholding agents that are required to file magnetically with the Social Security Administration must
likewise file magnetically or via e-mail with the Colorado Department of Revenue. Voluntary filing by this method is
encouraged. For further detailed information about this program, please contact the Colorado Department of Revenue at
(303) 866-5535 x 260 or visit the Fair Share Section Information page at
COMPLETING THE TRANSMITTAL FORM
Line 1
Total amount of state withholding withheld from all employees per W-2s and/or 1099s.
Total tax paid for the year. DO NOT INCLUDE PENALTY AND INTEREST IN THIS AMOUNT.
Line 2
Line 3
If amounts on lines 1 and 2 are the same, enter a zero on line 6.
Line 3A Additional tax - If line 1 is greater than line 2, complete lines 3A, 4, 5, and 6.
Line 3B Tax Refund - If line 2 is greater than line 1, complete line 3B.
F
DETACH HERE
F
13
DR 1093 (11/10/04)
Colorado Department of Revenue
Number of copies
TRANSMITTAL OF STATE W-2s and 1099s
1000-130
of W-2s attached
Total Colorado income
1
ACCOUNT NUMBER
PERIOD
DUE DATE
taxes withheld per wage
00
and tax statements attached
2
Total Colorado income taxes
F.E.I.N.
Social Security Number 1
Social Security Number 2
withheld and remitted for
calendar year indicated
00
SIGNED UNDER PENALTY OF PERJURY IN THE SECOND DEGREE
3
A. ADDITIONAL TAX DUE
00
(100)
or
B. REFUND
Signature
Date
Phone
00
(415)
If your check is rejected due to
insufficient or uncollected
00
4
PENALTY
(200)
funds, the Department of
Revenue may collect the
00
5
(300)
amount due directly from your
INTEREST
banking account electronically.
Mail reconciliation together with wage and tax statements or 1099 forms
TOTAL AMOUNT DUE
6
$
00
Paid by EFT
(355)
to: Colorado Department of Revenue, Denver, Colorado 80261-0009
with this report
?

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