Form Dr 0526 - Prepaid Wireless Surcharge Return Page 2
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3DR 0526 (08/25/16)
*DO=NOT=SEND*
COLORADO DEPARTMENT OF REVENUE
Denver, CO 80261-0009
Line 12: Interest - If return and/or payment is remitted
after the due date, multiply line 10 by interest
rate listed 0.25% (.0025). Enter amount.
Line 13: Total Remitted - Add lines 10, 11 and 12.
Enter the total amount to remit with return.
Check box if payment is by EFT. Make check
or money order payable to the Colorado
Department of Revenue. Be sure to write your
account number on your check.
Mail return and payment to:
Colorado Department of Revenue
Denver, CO 80261-0009
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