Form Dr 1101 - Annual Reconciliation Of Income Tax Withheld On Gaming Winnings printable pdf download

DR 1101 ( 03/15/11 )

COLORADO DEPARTMENT OF REVENUE

1375 SHERMAN STREET

DENVER, CO 80261-0009

Annual Reconciliation of Income Tax

Withheld on Gaming Winnings

Instructions

If you are filing an amended return you are required to check the

Compute the interest due at the statutory rate printed on the form.

amended return box. A separate amended return must be filed for

If there is an overpayment, put the amount of line 3B.

each period. The amended return must show all tax columns as

You must apply for a refund of the overpayment of tax by

corrected, not merely the difference(s). The amended return will

filing form DR 0137. This form may be obtained online at

replace the original return in its entirety.

Use this form to reconcile the amount of backup withholding

Do not send Forms W-2G with this form. Mail them to:

remitted with the total reported on Forms W-2G.

Colorado Department of Revenue

If additional tax is due, put the amount on line 3A. Compute

Attn: Discovery

penalty at the larger of 5% (.05) of the balance due for the first

1375 Sherman St., Rm. 634

month you are late and 1/2% (.005) additional penalty for each

Denver CO 80261-0009

additional month you are late. The maximum penalty is 12% (.12),

and the minimum penalty is $5.00.

▼ Photo Copy For Your Records Return Only The Coupon Below — Detach Here ▼

Annual Reconciliation of Income Tax

DR 1101 (03/15/11)

COLORADO DEPARTMENT OF REVENUE

Withheld on Gaming Winnings

DENVER, COLORADO 80261-0009

□

1010-130

Check here if this is an Amended Return .........................

●

Account Number

Period

Due Date

1. Total Colorado income tax withheld

per W-2Gs

Social Security Number 1

Social Security Number 2

FEIN

2. Total Colorado income taxes withheld

and remitted for calendar year

indicated.

Signed Under Penalty of Perjury in The Second Degree

3. A. ADDITIONAL TAX DUE

(100)

______________________________________

______________

B. TAX OVERPAYMENT

Signature

Date

Phone

(905)

(See instructions)

(200)

4. PENALTY (See instructions)

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

(300)

5. INTEREST (See instructions)

check is rejected due to insufficient or uncollected funds, the Department of Revenue may collect the payment

amount directly from your bank account electronically.

.00

(355)

6. Amount Owed

(Do not write in space below)

Form Dr 1101 - Annual Reconciliation Of Income Tax Withheld On Gaming Winnings

Related Articles

Related forms

Related Categories