Form 104x Draft - Amended Colorado Individual Income Tax Return

NET CHANGE

CORRECT

ORIGINAL AMOUNT

–

AMOUNT

“

”

INCREASE OR (DECREASE

)

OR AS PREVIOUSLY ADJUSTED

25 Federal Adjusted Gross Income ................................................... 25

26 Amount from line 24 on front of form (Net Tax) ............................ 26

27 Colorado income tax withheld ....................................................... 27

(27)

28 Estimated tax ................................................................................ 28

(28)

29 Child care credit from line 5 or 6, Form 104 CR ........................... 29

(29)

30 Total of lines 27 through 29 .......................................................... 30

31 If line 30 exceeds line 26, enter your overpayment ...................... 31

32 If line 26 exceeds line 30, enter the amount owed ....................... 32

COMPUTE THE AMOUNT YOU OWE

33 Enter any decrease shown on line 31 column 3 (NET CHANGE) .............................. 33

34 Enter any increase shown on line 32 column 3 (NET CHANGE) ............................... 34

35 Additional tax due, total of lines 33 and 34 ................................................................. 35

36 Interest due on additional tax - see instructions ......................................................... 36

(36)

37 Penalty due - see instructions ..................................................................................... 37

(37)

38 Estimated tax penalty due - see instructions .............................................................. 38

(38)

39 Payment due with this return, add lines 35 through 38 ............................................... 39

(39)

The State may convert your check to a one time electronic banking transaction. Your bank account may be debited as early as the same day received by the State. If converted, your check

will not be returned. If your check is rejected due to insufficient or uncollected funds, the Department of Revenue may collect the payment amount directly from your bank account electronically.

COMPUTE YOUR REFUND

40 Enter any increase shown on line 31 column 3 (NET CHANGE) ............................... 40

41 Enter any decrease shown on line 32 column 3 (NET CHANGE) .............................. 41

42 Refund claimed with this return, total of lines 40 and 41 ............................................ 42

(42)

43 Overpayment credited to 2008 estimated tax ............................................................. 43

(43)

44 Penalty reduced .......................................................................................................... 44

(44)

45 Estimated tax penalty reduced ................................................................................... 45

(45)

46 Interest allowed on refund. To be computed by Department of Revenue .................. 46

(46)

47 To be completed by Department of Revenue ............................................................. 47

(47)

Type:

Checking

Savings

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. To expedite your

refund, attach a copy of the federal record of account to support any changes to federal taxable income.

Form 104x Draft - Amended Colorado Individual Income Tax Return - 2007 Page 3

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