Fillable Form Dr 0900 - Individual Income Tax Payment Form

Form Dr 0900 - Individual Income Tax Payment Form - 2015

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DR 0900 (09/10/15)

*150900==19999*

COLORADO DEPARTMENT OF REVENUE

Denver CO 80261-0008

(0011)

2015 Individual Income Tax Payment Form

(Calendar year — Due April 18, 2016)

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 other electronic method and remit your

the amount entered on the payment form must be the

payment electronically or by EFT.

same. This will help maintain accuracy in your tax account.

Be sure to keep a copy of the money order or note the

However, to pay by mail, make check or money order

check number with your tax records.

payable to the Colorado Department of Revenue. Be sure

to round your payment to the nearest dollar. Clearly write

DO NOT submit a paper return if you have already filed

your Social Security number and “2015 Form 104” on the

electronically.

check memo line.

Return this form with check or money order payable to the Colorado Department of Revenue, Denver, Colorado 80261-0008. Write your

Social Security number and “2015 Form 104” on your check or money order. Do not send cash. Enclose, but do not staple or attach, your

payment with this form.

First Name

Middle Initial SSN

Your Last Name

Spouse Last Name (if joint)

Spouse First Name

Middle Initial Spouse SSN

Address

City

ZIP

State

IF NO PAYMENT IS DUE, DO NOT FILE THIS FORM.

Amount of Payment

The State may convert your check to a one time electronic banking transaction. Your 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.

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Form Dr 0900 - Individual Income Tax Payment Form - 2015

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