Form Dr 0133 - Passenger Mile Tax Return

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PASSENGER MILE
DR 0133 Web (05/18/10)
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
(100)
1. Passenger mile tax (DR 7011)
(925)
2. Passenger mile tax paid at ports
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
(300)
6. Interest
(355)
7. TOTAL DUE Add lines 4, 5 and 6
$
.
RETURN COPY BELOW — DETACH HERE
PASSENGER MILE
DR 0133 Web (05/18/10)
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
(925)
Signature
Date
Phone
2. Passenger mile tax paid at ports
(410)
3. Refund: only if line 2 is more
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
(300)
6. Interest
may collect the payment
amount directly from
(355)
7. TOTAL DUE: Add lines 4, 5 and 6
your banking account
$
.
DO NOT WRITE BELOW THIS LINE
electronically.

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