Form 104ep - Colorado Tax-Individuals Worksheet - 2012
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1
2FORM 104EP (10/28/11)
COLORADO DEPARTMENT OF REVENUE
2012
DENVER, CO 80261-0008
COLORADO
Estimated Tax — Individuals
WORKSHEET
(Instructions available on back)
1. Estimated 2012 Colorado taxable income
00
2. Estimated 2012 Colorado income tax — 4.63% of line 1
00
3. Estimated 2012 Colorado alternative minimum tax
00
4. Estimated 2012 recapture of prior year credits
00
5. Total of lines 2, 3 and 4
00
6. Estimated 2012 Form 104CR credits
00
7. Line 5 minus line 6
00
8. Estimated 2012 Colorado withholding tax
00
00
9. Net estimated tax, line 7 minus line 8
Payment Number
Net Amount Due
2011 Overpayment Applied
Payment Due
Due Dates
1
$
$
$
April 17
2
$
$
$
June 15
3
$
$
$
September 15
4
$
$
$
January 15, 2013
Round your payment to the nearest dollar. If paying by check, the amount on the check and the amount entered on the
payment voucher must be the same. This will help maintain accuracy in your tax account. It is strongly recommended that
estimated payments be submitted online to avoid problems or delays with the 2012 income tax return.
Due Dates: If the due date falls on a weekend or federal holiday, payment will be due the next business day.
Only use this coupon if you are not able to pay online or by EFT.
Manage your account.
File and pay online.
Get started with Revenue Online today!
DETACH FORM
ON THIS LINE
Cut here and send only the coupon below. Help us save time and your tax dollars.
2012 Colorado Estimated Income Tax
(0012)
FORM 104EP (10/28/11)
Payment Voucher
70
COLORADO DEPARTMENT OF REVENUE
Return this voucher with check or money order payable to the Colorado Department of Revenue, Denver, Colorado 80261-0008. Write your Social Security
number and “2012 FORM 104EP” on your check or money order. Do not send cash. Enclose, but do not staple or attach, your payment with this voucher.
File only if you are making a payment of estimated tax and are unable to pay online or by EFT.
Your Last Name
First Name and Initial
Your Social Security Number
Spouse’s Last Name
First Name and Initial
Spouse’s Social Security Number
Address
City
State
ZIP
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
(08)
funds, the Department of Revenue may collect the payment amount directly from your bank account electronically.
$
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(Do not write in space below)
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