*150900P=19999*
DR 0900P (07/17/15)
COLORADO DEPARTMENT OF REVENUE
Denver CO 80261-0008
(0041)
2015 Pass-Through Entity Income Tax Payment Form
Caution!
This form MUST accompany your payment if you filed electronically and wish to pay by check.
The Department strongly recommends that you file using
Complete the form below. The amount on the check and
Revenue Online ( ) or
the amount entered on the form must be the same. This
another electronic method and remit your payment
will help maintain accuracy in your tax account. Be sure to
electronically or by EFT. Information on EFT can be found
keep a copy of the money order or note the check number
with your tax records.
at
If you cannot file and pay online, you may pay by mail.
Do not submit a paper return if you have already filed
Make check or money order payable to the Colorado
electronically.
Department of Revenue. Be sure to round your payment
Manage your account. File and pay online.
to the nearest dollar. Clearly write your Colorado Account
Get started with Revenue Online today!
Number and “2015 Form 106” on the check memo line.
DR 0900P (07/17/15)
COLORADO DEPARTMENT OF REVENUE
Denver CO 80261-0008
Beginning
Ending
(MM/DD/2015)
(MM/DD/YYYY)
For the calendar year 2015 or the fiscal year
Return this form with check or money order payable to the Colorado Department of Revenue, Denver, Colorado 80261-0008. Write your Colorado
Account Number or Federal Employer Identification Number and “2015 FORM 106” on your check or money order. Do not send cash. Enclose,
but do not staple or attach, your payment with this form.
Last Name or Business Name
First
Middle Initial
Colorado Account Number
FEIN
Address
City
State
Zip
Amount of Payment
The State may convert your check to a one time electronic banking transaction. Your
If No Payment Is Due, Do Not File This Form.
bank account may be debited as early as the same day received by the State. If converted, your check will not be returned. If your check is rejected
due to insufficient or uncollected funds, the Department of Revenue may collect the payment amount directly from your bank account electronically.
$
.00