Form 105 - Colorado Fiduciary Income Tax Return

Form 105 - Colorado Fiduciary Income Tax Return - 2011 Page 11

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2011 Colorado Nonresident Beneficiary

Form 104BEP (11/03/11)

Estimated Income Tax Payment Voucher

colorado deParTmenT oF reVenue

Payment for Nonresident Beneficiary — see instructions on Page 3

For tax period ______________________, 2011, ending _________________________ .

Return this voucher with check or money order payable to the Colorado Department of Revenue, Denver, Colorado 80261-0008. Write the beneficiary’s social security number

and “ 2011 Form 104BEp” on the check or money order. Do not send cash. File only if you are making a payment. submit a separate check or money order for each document.

Payment is due at the time the income is distributed.

Beneficiary’s last Name

First Name and middle Initial

Address

social security Number

City

State

ZIP

IF No pAymENT Is DuE, Do NoT FIlE ThIs FoRm.

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

Amount of Payment

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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