Form Dr 0225 - Tobacco Products Tax Return For Non-Licensed Distributors

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DR 0225 (01/31/12) Web
COLORADO DEPARMENT OF REVENUE
DENVER CO 80261-0009
TOBACCO PRODUCTS TAX RETURN
FOR NON-LICENSED DISTRIBUTORS
General Instructions
Enter the gross purchases of tobacco products,
Who Must File
Line 1.
This return must be filed by all persons or entities, who are
at manufacturer’s list price, for the reporting
not licensed tobacco distributors, receiving untaxed tobacco
period. ‘Manufacturer list price’ means the
products from a distributor who neglected to remit taxes.
invoice price for which a manufacturer or
Tobacco products do not include factory rolled cigarettes.
supplier sells a tobacco product to a non-
This return must be filed within thirty (30) days of taking
licensed distributor exclusive of any discount or
possession of the product.
other reductions.
Enter the amount of purchases for which excise
Instructions
Line 2.
Enter your DOR sales tax or account number, your name
tax has already been paid to the State of Colorado.
or the establishment name, month and year tobacco was
(Attach copies of invoices).
purchased, your FEIN number or social security number,
Total untaxed tobacco products, Subtract line 2
Line 3.
and your address. Sign and date in the spaces provided.
from line 1.
If RYO tobacco was purchased, list brand of RYO tobacco
Tax Due. Multiply line 3 by 40% (0.40).
Line 4.
and total ounces purchased, by brand.
Penalty. If return is filed more than thirty (30) days
Line 5.
Please send return and make payment to:
after taking possession multiply line 4 by 500%
(5.0)
Colorado Department of Revenue
1375 Sherman Street
Interest. Interest percentage is per month
Line 6.
Denver, CO 80261-0009
imposed under Section 39-21-110.5.
AMOUNT OWED. Add lines 4, 5 and 6.
Line 7.
Cut here and send only the coupon below. Help us save time and your tax dollars.
DR 0225 (01/31/12) Web
TOBACCO PRODUCTS TAX RETURN
COLORADO DEPARTMENT OF REVENUE
Denver CO 80261-0009
FOR NON-LICENSED DISTRIBUTORS
DOR Account Number (if applicable)
Period (MM/YYYY)
FEIN or SS#
0225-100
Name
Address
City
State
ZIP
Signed under penalty of perjury in the second degree
1. Total gross purchases of tobacco
00
products (Manufacturer’s list price) .........
2. Deduct purchases of Tax-Paid
00
tobacco products.....................................
Signature
Date
00
3. Taxable purchases (line 1 minus line 2)
If RYO tobacco has been purchased, list brand name and total ounces per brand purchased.
00
Brand
Ounces
4. Tax due. (line 3 multiplied by 40% (.40) ..
5. If return is filed more than thirty (30) days
after first taking possession multiply line 4
00
by 500% (5.0)
00
6. Interest. ..................................... _______.
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
7. AMOUNT OWED
uncollected funds, the Department of Revenue may collect the payment amount directly from your bank account electronically.
$
. 0 0
(add lines 4, 5 and 6)
(Do not write in space below)

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