Form 104-Ep - Estimated Income Tax Payment Voucher - 2001

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DO YOU WANT TO AVOID MAILING THESE FORMS?
If so, file and pay your estimated income taxes electronically. With one phone call, you can pay your estimated tax without writing a check, or mailing anything.
When it is time to pay estimated tax, you dial a toll-free number; enter your EFT authorization number, a password, tax type codes, filing period, and dollar amount.
The next day, the money will be transferred to the Department of Revenue and credited to your account.
To sign up, fill out the next page and send to
Colorado Department of Revenue
Sample Check:
2259
Denver, CO 80261-0005
_________________ 19____
880
23-7
1020
Pay to the order of:
Anytown Bank Center, 1A Street, Anytown USA 80000
Anytown Bank
National Association (303) 000-0000
VOID
For
Transit and Routing Number
Bank Account Number Check #
102000076
1011234567
DR 5774 (10/00)
EFT AUTHORIZATION
EFT Number
COLORADO DEPARTMENT OF REVENUE
DENVER CO 80261-0005
3 7 1 0
INDIVIDUAL INCOME TAX
___ ___ ___ ___ ___ ___ ___ ___ ___ ___
(303) 866-2388
To be assigned by Department of Revenue
Taxpayer Name
01204
Mailing Address
Social Security Number
City
State
ZIP
Contact Person
Phone
(
)
I authorize the Colorado Department of Revenue,
pursuant to my instructions, to initiate entries to my account number ________________________ at __________________________________ bank.
Name of Bank Account
Type of Account
Checking
Savings
Bank Transit/Routing Number
Signature
Date
A VOIDED CHECK FOR THE BANK ACCOUNT INDICATED ABOVE MUST ACCOMPANY APPLICATION

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