Form Dr 1210 - Colorado Estate Tax Return
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2DR 1210 (10/03)
COLORADO ESTATE TAX RETURN
COLORADO DEPARTMENT OF REVENUE
1375 SHERMAN STREET
DUE DATE: ON OR BEFORE THE DATE THE
DENVER CO 80261
FEDERAL RETURN IS REQUIRED TO BE FILED.
TO BE FILED ONLY IF DATE OF DEATH IS ON OR AFTER JANUARY 1, 1980. CHECK THE
APPLICABLE STATEMENT LISTED BELOW:
A Federal return is not required to be filed but a Certificate of Estate Tax Determination
is requested. Complete Sections I and II below.
A Federal return is attached but no Colorado estate tax is due. A Certificate of
Estate Tax Determination is requested. Complete Sections I and II below.
A Federal return is attached and a Colorado estate tax is due. A Certificate of Estate
Tax Determination is requested.
Department of Revenue Use Only
FOR DEPARTMENT USE ONLY
ACCOUNT NUMBER: L2126495
PERIOD _____________________
LIABILITY: 2800-800
(999) $
Attached is a payment for Colorado tax in amount
Decedent was:
The amount of payment was computed in accordance with Schedule A, B, C and
Domiciliary
Recapitulation page 2.
Non-Domiciliary
of Colorado.
Alien
An extension of time to file the Federal return
has
has not been approved.
The Estate has elected
A true copy of such approved extension is attached. Extension date: ________________________
10 yr
15 yr
installment payments.
An extension of time to pay the Federal tax
has
has not been approved.
First payment due date:
A true copy of such approved extension is attached. Extension date: _______________________
____________________
SECTION I
Estate of
Date of Death
Decedent's Social Security Number
Domicile at Date of Death (Number and Street)
City
County
State
Zip
Name of Personal Representative or person filing return
Address (Number and Street)
City
State
Zip
Telephone
Name of Attorney
Address (Number and Street)
City
State
Zip
Telephone:
SECTION II
Enter the total gross value of the decedent's estate. Gross value means the total value of assets before any deductions.
Colorado Assets
Non-Colorado Assets
TOTAL
I declare, under penalties of perjury in the second degree, that I have examined this return including any and all accompanying
schedules or attachments and that I believe the same to be true and correct as to every material matter.
Signature of person filing return
Title
Date
Signature of person preparing return
Title
Date
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