Form Dr 1318 - Unlicensed Child Care Organization Registration Application
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DR 1318 (08/02/13)
COLORADO DEPARTMENT OF REVENUE
Denver, CO 80261-0005
Unlicensed Child Care Organization Registration Application
Organization Name
Colorado Account Number, if applicable
Indicate Type of Organization
Non-profit 501(C)(3)
Individual
Limited Liability Limited
Estate
Partnership (LLLP)
(Please enclose copy of the
General Partnership
Government
IRS letter of exemption.)
Corporation
Limited Partnership
Joint Venture
Other Non-profit
S Corporation
Limited Liability Company (LLC)
Trust
Other
Association
Limited Liability Partnership (LLP)
Trade Name/Doing Business As (if applicable)
FEIN
Address of Principal Place of Business in Colorado
City
State
Zip
County
Phone Number
(
)
In Care of (C/O)-Last Name
First Name
Middle Initial
Mailing Address (if different from above, include Unit #)
City
State
Zip
Check One
Register an unlicensed child care program.
Register a grant or loan program for parents in Colorado requiring financial assistance for child care.
Register a training program for child care providers.
Register an information dissemination program in Colorado to provide information and referral services to assist
parents in obtaining child care.
Explain why donations to this organization qualify for the child care contribution credit.
Do all of your programs qualify for the credit?
Yes
No
If not, specify which programs do qualify.
Why is a Department of Human Services license not required?
Attach copies of brochures, newspaper articles, community publications and other documentation to support the
information above.
I declare under penalty of perjury in the second degree that the statements made in this application are true and
complete to the best of my knowledge.
Name of Organization Officer
Title
Signature of Organization Officer
Date
(MM/DD/YY)
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Parent category: Financial