Form Dr 0133 Web - Passenger Mile Tax Return

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DR 0133 Web (05/18/10)
PASSENGER MILE
COLORADO DEPARTMENT OF REVENUE
DENVER, CO 80261-0016
TAX RETURN
(303) 205-8205
KEEP THIS COPY
Account Number
Period
Due Date
Industry Code
Social Security Number 1
Social Security Number 2
FEIN
5140-100
1. Passenger mile tax (DR 7011)
(100)
2. Passenger mile tax paid at ports
(925)
MAKE CHECK PAYABLE TO COLORADO
3. Refund: only if line 2 is more
(410)
DEPARTMENT OF REVENUE.
than line 1
INCLUDE THE ACCOUNT NUMBER ON YOUR
4. Balance due if line 1 is more than line 2
CHECK TO ENSURE PROPER CREDIT.
5. Penalty
(200)
MAIL TO: Colorado Department of Revenue
Denver, Colorado 80261-0016
6. Interest
(300)
7. TOTAL DUE Add lines 4, 5 and 6
(355)
$
.
RETURN COPY BELOW — DETACH HERE
DR 0133 Web (05/18/10)
PASSENGER MILE
COLORADO DEPARTMENT OF REVENUE
DENVER, CO 80261-0016
TAX RETURN
(303) 205-8205
Account Number
Period
Due Date
Industry Code
Social Security Number 1
Social Security Number 2
FEIN
5140-100
1. Passenger mile tax (DR 7011)
(100)
SIGNED UNDER PENALTY OF PERJURY IN THE SECOND DEGREE
Signature
Date
Phone
2. Passenger mile tax paid at ports
(925)
3. Refund: only if line 2 is more
(410)
than line 1
4. Balance due if line 1 is more than line 2
If your check is returned
due to insufficient or
5. Penalty
(200)
uncollected funds, the
Department of Revenue
6. Interest
(300)
may collect the payment
amount directly from
7. TOTAL DUE: Add lines 4, 5 and 6
(355)
your banking account
$
.
DO NOT WRITE BELOW THIS LINE
electronically.

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