Form 104 - Colorado Individual Income Tax - 2011

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Departmental Use Only
2011
FORM 104
Vendor ID
(0013)
COLORADO INDIVIDUAL INCOME TAX
FULL-YEAR RESIDENT(S)
RESIDENCY
PART-YEAR RESIDENT(S) OR NONRESIDENT(S)
STATUS
(or resident, part-year, nonresident combinations)
(CHECK ONE)
ABROAD ON DUE DATE
For calendar year 2011 or fiscal year _____________
LAST NAME
FIRST NAME AND INITIAL
DECEASED
SOCIAL SECURITY NUMBER
Yourself
YES
Spouse, if joint
YES
Mailing Address
Your telephone number
(
)
City
State
ZIP Code
Email Address
ROUND TO THE NEAREST DOLLAR
1. EntEr FEDErAL tAXABLE InCOME from your federal income tax return: 1040EZ line 6;
00
1040A line 27; 1040 line 43 .......................................................................................................................
1
ADDITIONS
2. StAtE ADDBACK enter the state income tax deduction from your federal 1040
00
schedule A (see instructions) ....................................................................................................................
2
00
3. OtHEr ADDItIOnS, explain (see instructions) ........................................................................................
3
00
4. Subtotal, add lines 1–3 ................................................................................................................................ 4
SUBTRACTIONS
00
5. StAtE InCOME tAX rEFUnD enter the state income tax refund from line 10 of your federal 1040 ......
5
00
6. US GOVErnMEnt IntErESt ................................................................................................................
6
00
7. PrIMArY tAXPAYEr PEnSIOn/AnnUItY income (Beneficiaries, list deceased’s SSn: ____________)
7
00
8. SPOUSE PEnSIOn/AnnUItY income, if any (Beneficiaries, list deceased’s SSn: ____________) ......
8
00
9. COLOrADO SOUrCE CAPItAL GAIn 5-year assets acquired on or after 5/9/1994 ..............................
9
10. tUItIOn PrOGrAM COntrIBUtIOn:
total Contribution $_______________________
00
Owner’s name _____________________
Owner’s SSn ___________________ (see instructions) . 10
00
11. QUALIFYInG CHArItABLE COntrIBUtIOn
total Contributions $ ___________________ ............... 11
12. OtHEr SUBtrACtIOnS, check appropriate box:
PErA contribution made in 1984–1986;
DPSrS contributions made in 1986;
tier I or II railroad benefits;
qualified reservation income
00
wildfire mitigation measures. ................................................................................................................. 12
00
13. Subtotal, add lines 5 through 12 .................................................................................................................. 13
00
14. COLOrADO tAXABLE InCOME, line 4 minus line 13 ............................................................................. 14
CALCULATE YOUR TAX: FULL-YEAR RESIDENTS TURN TO PAGE 22 PART-YEAR RESIDENTS AND NONRESIDENTS GO TO 104PN
TAX, PREPAYMENTS AND CREDITS
00
15. COLOrADO tAX from tax table or 104Pn line 36 ............................................................... 15
00
16. ALtErnAtIVE MInIMUM tAX from Form 104AMt ............................................................ 16
00
17. rECAPtUrE of prior year credits........................................................................................ 17
00
18. Subtotal, add lines 15 through 17 ............................................................................................18
00
19. nOn-rEFUnDABLE CrEDItS from 104Cr line 49, cannot exceed the sum of lines 15 + 16 . 19
00
20. nEt tAX, subtract line 19 from line 18....................................................................................20
00
21. COLOrADO InCOME tAX WItHHELD from W-2 and 1099 statements ............................ 21
22. EStIMAtED tAX enter the sum of payments and credits and amounts withheld from
00
nonresident real estate sales and partnership/S corp/fiduciary income ............................... 22
00
23. rEFUnDABLE CrEDItS from 104Cr line 9....................................................................... 23
00
24. Subtotal, add lines 21 through 23 ............................................................................................24
25. FEDErAL ADJUStED GrOSS InCOME from your federal income tax return:
00
1040EZ line 4; 1040A line 21; 1040 line 37 .......................................................................... 25
00
26. OVErPAYMEnt, if line 24 is greater than 20 then subtract line 20 from line 24 ....................26

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