Form Dr 1319 - Child Care Contribution Tax Credit Grandfathered Organization Application
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DR 1319 (07/23/13)
COLORADO DEPARTMENT OF REVENUE
Denver, CO 80261-0005
Child Care Contribution Tax Credit
Grandfathered Organization Application
Organization Name
Telephone Number
(
)
License Number or DOR Registration Number
FEIN
Address
City
State
Zip
List the specific eligible programs for which the organization accepted qualifying donations for the child care contribution credit.
Did the programs listed above include children ages 13-17?
Yes
No
If yes, briefly explain
Provide a list of donors who claimed the credit during tax years 1999 to 2003.
Attach copies of brochures, newspaper articles, community publications and other documentation to support the
information on eligible programs listed above. Attach additional pages if needed.
Name of Organization Officer
Title
Signature of Organization Officer
Date
(MM/DD/YY)
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