*150104V239999*
FORM 104 (11/16/15)
COLORADO DEPARTMENT OF REVENUE
Denver, CO 80261-0005
Name
Account Number
Tax, Prepayments and Credits: full-year residents turn to page 26 and part-year and nonresidents go to 104PN
26. Colorado Tax from tax table or 104PN line 36
26
0 0
27. Alternative Minimum Tax from Form 104AMT
27
0 0
28. Recapture of prior year credits
28
0 0
29. Use Tax: Enter the total purchases for which sales or use tax was not
previously paid
29
0 0
30. Multiply line 29 by 0.029. Enter the result in whole dollars here.
30
0 0
31. Enter the SDCU Code for any applicable special district(s). See instructions.
31
32. Enter the corresponding use tax rate. See instructions.
32
33. Multiply line 29 by the rate on line 32. Enter the result in whole dollars here.
33
0 0
34. Subtotal, add lines 26 through 28 and lines 30 and 33
34
0 0
35. Nonrefundable Credits from 104CR line 35, cannot exceed the
sum of lines 26 and 27
35
0 0
36. Total Nonrefundable Enterprise Zone credits used – as calculated,
or from DR 1366 line 87
36
0 0
37. Net Tax, subtract lines 35 and 36 from line 34
37
0 0
38. CO Income Tax Withheld from W-2s and 1099s.
38
0 0
39. Prior-year Estimated Tax Carryforward
39
0 0
40. Estimated Tax Payments, enter the sum of the quarterly payments
remitted for this tax year
40
0 0
41. Extension Payment remitted with form 158-I
41
0 0
42. Other Prepayments:
104BEP
DR 0108
DR 1079
42
0 0
43. Gross Conservation Easement Credit from DR 1305G line 33
43
0 0
44. Innovative Motor Vehicle Credit from form DR 0617
44
0 0
45. Refundable Credits from 104CR line 8
45
0 0