Form Dr 0100 - Colorado Retail Sales Tax Return Page 2
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3DR 0100 (12/13/16)
*160100==29999*
COLORADO DEPARTMENT OF REVENUE
Denver, CO 80261-0013
Colorado Account Number (XXXXXXXX-XXXX)
Name
Period
(MM/YY-MM/YY)
–
Additions
10. Tax on
(10-1)
(10-2)
(10-3)
(10-4)
(10-5)
inventory
00
00
00
00
00
usage
$
(11-1)
(11-2)
(11-3)
(11-4)
(11-5)
11. Total tax due
00
00
00
00
00
(add lines 9 & 10)
(12-1)
(12-2)
(12-3)
(12-4)
(12-5)
00
00
00
00
00
12. Penalty
(13-1)
(13-2)
(13-3)
(13-4)
(13-5)
13. Interest
00
00
00
00
00
14. Total each tax
00
00
00
00
00
(add lines 11, 12, & 13)
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,
15. Total Amount Owed
your check will not be returned. If your check is rejected due to insufficient or uncollected
Paid by EFT
(add all columns
funds, the Department of Revenue may collect the payment amount directly from your bank
$
. 0 0
(355)
on line 14)
account electronically.
Deductions Schedule- Part A
This schedule is required for deductions claimed on line 2b, page 1.
(A1-1)
1. Service sales
00
(A2-1)
2. Sales to governmental agencies, religious or charitable organizations
00
(A3-1)
3. Sales of gasoline
00
(A4-1)
4. Sales of drugs by prescription and prosthetic devices
00
(A5-1)
5. Trade-ins for taxable resale
00
(A6-1)
6. Bad debts charged-off, returned goods, trade discounts and allowances where tax was paid
(cash discounts are not allowed)
00
(A7-1)
7. Cost of utilities, excluding tax. Restaurants must complete and attach form, DR 1465.
00
(A8-1)
8. Sales of agricultural compounds and pesticides
00
(A9-1)
9. Other Deductions, explanation required
00
Explain
Total add lines 1 through 9. Enter total deductions on line 2b, page 1.
Total
00
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