Form Dr 1317 - Child Care Contribution Tax Credit Certification
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1DR 1317 (07/19/13)
*131317==19999*
COLORADO DEPARTMENT OF REVENUE
Denver, CO 80261-0005
Child Care Contribution
Tax Credit Certification
Organization Name
License Number or Colorado Account Number
FEIN
Address
Telephone Number
(
)
City
State Zip
Last Name of Preparer
First Name
Middle Initial
Signature of Preparer
Donor Last Name
First Name
Middle Initial
SSN or Colorado Account Number
Address
City
State Zip
Date of donation
(MM/DD/YY)
Credit Computation
1. Donation amount
$
2. Non-qualifying donation
$
3. Qualifying donation, line 1 minus line 2
$
4. Credit available, line 3 times 50%
$
Application of Donation
All functions of the donee organization qualify for the tax credit.
The donation is applied 100% to qualified programs to the organization.
Qualified programs that constitute
for all organization programs.
%
Other (describe allocation below)
Describe allocation
Instructions
This form is to be completed by the donee organization,
Social Security number may be completed by the donor
then given to the donor. The donee organization should
after receipt from the donee organization.
retain completed copies for record keeping.
Donors shall submit this form with their Colorado income
tax return when claiming the child care contribution credit.
When filing electronically, attach this form as a PDF to the
electronic return, upload a copy in Revenue Online or mail
with form DR 1778.
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