Form Dr 0122 - International Fuel Tax Agreement Tax Report - Colorado Department Of Revenue Page 2
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ENTER the total miles traveled in all other jurisdictions that are not members of IFTA
MAKE CHECK PAYABLE
13. Net Tax Due (Total Column 10)
(100)
AND MAIL REPORT TO:
14. Net Tax CREDIT (Total Column 10)
(105)
Colorado Department of Revenue
15. PENALTY ($50.00 or 10% of Column 10, whichever is greater)
(200)
1375 Sherman St.
16. INTEREST (Total Column 11)
(300)
Denver, CO 80261-0016
17. Amount of TAX CREDIT to be refunded this period
(410)
Photocopy and keep for
18. TOTAL REMITTANCE
your own records.
(A seperate check must accompany each return submitted)
(355)
I certify under penalty of perjury In the second degree that to the best of my knowledge the above information is true and correct.
Signature
Date
Title
Telephone Number
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Parent category: Financial