Form 104pn - Part-Year Resident/nonresident Tax Calculation Schedule - 2015
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1
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3FORM 104PN (11/16/15)
*150104PN19999*
Form 104PN
COLORADO DEPARTMENT OF REVENUE
Denver, CO 80261-0005
Part-Year Resident/Nonresident Tax
Calculation Schedule 2015
Taxpayer’s Name
SSN
Use this form if you and/or your spouse were a resident of another state for all or part of 2015. This form apportions your
gross income so that Colorado tax is calculated for only your Colorado income. Complete this form after you have filled
out lines 1 through 20 of Form 104. If you filed federal form 1040NR, see the instructions.
Beginning
Ending
(MM/YY)
(MM/YY)
to
Part-Year Resident from
1.
Taxpayer is (mark one):
Full-Year Nonresident;
Full-Year Resident
Nonresident 305-day rule Military
Beginning
Ending
(MM/YY)
(MM/YY)
to
Part-Year Resident from
2.
Spouse is (mark one):
Full-Year Nonresident;
Full-Year Resident
Nonresident 305-day rule Military
Mark the federal form you filed:
3.
1040 NR
1040
1040 A
1040 EZ
Other
Federal
Colorado
Information
Information
4. Enter all income from form 1040 line 7; 1040A line 7; or form 1040EZ line 1
4
00
5. Enter income from line 4 that was earned while working in Colorado and/
or earned while you were a Colorado resident. Part-year residents should
include moving expense reimbursements only if paid for moving into Colorado
5
00
6. Enter all interest/dividend income from form 1040 lines 8a and 9a; form
1040A lines 8a and 9a; or form 1040EZ line 2
6
00
7.
Enter income from line 6 that was earned while you were a resident of
Colorado
7
00
8. Enter all income from form 1040 line 19; form 1040A line 13; or form 1040EZ
line 3
8
00
9. Enter income from line 8 that is from State of Colorado unemployment
benefits; and/or is from another state’s benefits that were received while you
were a Colorado resident
9
00
If you filed federal form 1040EZ, go to line 24. All others continue with line 10.
10. Enter all income from form 1040 lines 13 and 14; or form 1040A line 10
10
00
11. Enter income from line 10 that was earned during that part of the year you
were a Colorado resident and/or was earned on property located in Colorado
11
00
12. Enter all income from form 1040 lines 15b, 16b, and 20b; or form 1040A lines
11b, 12b, and 14b
12
00
13. Enter income from line 12 that was received during that part of the year you
were a Colorado resident
13
00
If you filed federal form 1040A, go to line 20. If you filed form 1040, continue with line 14.
14. Enter all business and farm income from form 1040 lines 12 and 18
14
00
15. Enter income from line 14 that was earned during that part of the year you
were a Colorado resident and/or was earned from a Colorado operation
15
00
16. Enter all Schedule E income from form 1040 line 17
16
00
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