Form 104X Individual Amended Return

1040 EZ 1040 NR 14 15 Enter income from line 14 that was earned during that part of the year you were a Educatorexpenses IRAdeduction businessexpensesofreservists performingartistsand fee basis government officials health savings account deduction self employment tax self employed health insurance deduction SEP and SIMPLE deductions are allowed Enter in column (a) the total credit generated in 2011 and any carryforward credit that is available from a prior year Enter in column (b) the portion of the credit in column (a) that is being used to offset tax in 2011 If column (a) is larger than column (b) and the credit can be carried forward to future years enter the carryforward information on line 50 Full Year Nonresident; Full Year Resident Full Year Resident If you are unable to file electronically the documentation must be attached to this schedule and submitted with Form 104 Other attach explanation Owner s Name Part Year Resident from /11 to /11; PERA contribution made in 1984 1986; Purchased Reason for amended return (check one): Investment credit carryback from tax year ending Federal net operating loss carryback from tax year ending Student loan interest deduction alimony and tuition and fees deduction are allowed The Colorado capital gain subtraction to the extent included on line 11 above Use this schedule to determine which tax credits you are eligible to claim and what information has to be provided for each credit Vehicle Identification Number (VIN) wildfire mitigation measures $0 $25 000 50% $25 000 $35 000 30% $35 000 $60 000 10% (0015) AMENDED COLORADO INDIVIDUAL INCOME TAX RETURN (10/18/11) (12/19/11) (only if Colorado tax withheldis reported on the form) 00 00 00 00 00 00 00 00 00 00 1 ADDITIONS 1 ENTER FEDERAL TAXABLE INCOME from your federal income tax return: 1040EZ line 6; 1040A line 27; 1040 line 43 1 Federal adjusted gross income from federal Form 1040 line 37 or federal Form 1040A line 21 If line 1 is larger than $60 000 enter 0 on line 5 You do not qualify for this credit 10 Enter all income from Form 1040 lines 13 and 14; or Form 1040A line 10 10 TUITION PROGRAM CONTRIBUTION: Total Contribution $ 104 excluding any charitable contribution adjustments 1040 A 11 Enter income from line 10 that was earned during that part of the year you were a Colorado resident and/or was earned on property located in Colorado 11 QUALIFYING CHARITABLE CONTRIBUTION 12 Enter all income from Form 1040 lines 15b 16b and 20b; or Form 1040A lines 11b 12b and 14b 12 OTHER SUBTRACTIONS check appropriate box: 13 15 17 and 19 21 13 Enter income from line 12 that was received during that part of the year you were a Colorado resident 14 Enter all business and farm income from Form 1040 lines 12 and 18 15 00 15 COLORADO TAX from tax table or 104PN line 36 15 16 ALTERNATIVE MINIMUM TAX from Form 104AMT 16 16 Enter all Schedule E income from Form 1040 line 17 17 Enter income from line 16 that was earned from Colorado sources; and/or rent and royalty income received or credited to your account during that part of the year you were a Colorado resident; and/or partnership/S corporation/fiduciary income apportioned based on the number of days of Colorado residency during the corporation/partnership/fiduciary tax year 17 RECAPTURE of prior year credits 17 18 Enter all other income from Form 1040 lines 10 11 and 21 (list type ) 19 Enter income from line 18 that was earned or received during that part of the year you were a Colorado resident and/or was received from Colorado sources (list type ) 2 Federal tax from federal Form 1040 line 46 or federal Form 1040A line 28 If line 2 is 0 enter 0 on line 5 2 STATE ADDBACK enter the state income tax deduction from your federal 1040 2011 FORM 104X 21; or Form 1040EZ line 4 24 22 Enter all federal adjustments from Form 1040 line 36 or Form 1040A line 20 (list type ) 23 00 23 Enter adjustments from line 22 as follows: (list type ) 24 AdjustedGrossIncome EnteramountfromForm1040line37;orForm1040Aline 26 OVERPAYMENT if line 24 is greater than 20 then subtract line 20 from line 24 26 00 27 00 27 AdditionstoColoradoAdjustedGrossIncome Enteranyamountfromline26thatis 27 Enter the overpayment from your original return or as previously adjusted 27 00 28 If line 20 is larger than line 24 enter the amount owed 28 00 28 Total of lines 24 and 26 28 29 Enter the amount owed from your original return or as previously adjusted 29 00 3 OTHER ADDITIONS explain (see instructions) 3 The 2011 federal child care credit you claimed Enter the smaller of the amounts on line 46 or 48 of your federal Form 1040 or the smaller of the amounts on line 28 or 29 of your federal Form 1040A 30 Plastic recycling investment credit (See FYI 56) 30 Plastic recycling net expenditures amount $ Submit a copy of the receipt and other required documentation when claiming this credit 00 30 SubtractionsfromAdjustedGrossIncome Entertheamountfromline13ofColorado 31 Colorado minimum tax credit (See FYI 14) 31 2011 federal minimum tax credit $ 00 31 SubtractionsfromColoradoAdjustedGrossIncome Enteranyamountfromline30 32 Historic property preservation credit (See FYI 1) 32 2011 credits reported in column (a) must be carried forward to 2012 Submit a copy of the verification form or copy of the federal credit calculation when claiming this credit 00 32 ModifiedAdjustedGrossIncome Subtracttheamountonline30fromtheamount 33 Child care center investment credit (See FYI 7) 33 Submit proof that you operate a licensed child care facility when claiming this credit 00 33 Interest due on additional tax 33 ModifiedColoradoAdjustedGrossIncome Subtracttheamountonline31fromthe 34 Employer child care facility investment credit (See FYI 7) 34 Submit proof that you operate a licensed child care facility when claiming this credit 00 34 Penalty due 35 Estimated tax penalty due 35 School to career investment credit (See FYI 32) 35 Submit a copy of your certification letter when claiming this credit 00 36 Colorado works program credit (See FYI 34) 36 Submit a copy of the letter from the county Dept of Social/Human Services when claiming this credit 00 36 Payment due with this return add lines 32 through 35 Paid by EFT 37 Child care contribution credit 37 Credits for 2011 donations reported in column (a) must be carried forward to a 2013 return (See FYI 35) Donation amount $ Date of last donation Submit a copy of Form DR 1317 when claiming this credit 00 37 Line 26 minus line 27 but not less than zero 38 Line 29 minus line 28 but not less than zero 38 Rural technology enterprise zone credit (carryforward from 2004 only) (See FYI 36) 38 Submit a copy of the PUC certification when claiming this credit 00 39 Long term care insurance credit (See FYI 37) 39 Submit a copy of a year end statement disclosing the premiums paid when claiming this credit 00 4 Your percentage from the table below 4 40 Contaminated land redevelopment credit (See FYI 42) 40 Submit a copy of the CDPHE certification when claiming this credit 00 41 Low income housing credit (carryforward from 2002 only) (See FYI 46 ) 41 Submit a copy of the CHFA certification when claiming this credit 00 41 Refund claimed with this return line 39 minus line 40 42 Aircraft manufacturer new employee credit (See FYI 62) 42 Submit a copy of forms DR 0085 and DR 0086 when claiming this credit 00 43 Gross conservation easement credit (See FYI 39) 43 Submit form DR 1305 when claiming this credit Easement donors must also submit the additional required documentation including the full easement appraisal Due to the large amount of data required it is strongly suggested that this information be provided electronically through Revenue Online to avoid problems with lost data 00 44 Job growth incentive tax credit (See FYI 66) 44 00 45 Colorado innovation investment tax credit (See the Income Tax Index) 45 00 46 Alternative fuel refueling facility credit (carryforward from 2010 only) (See the Income Tax Index) 46 00 47 Nonrefundable alternative fuel vehicle credit (carryforward from 2009 only) (See FYI 9) 47 00 48 Total of lines 30 through 47 column (b) 48 00 49 Total non refundable credits add lines 21 29 and 48 Enter here and on line 19 of Form 104 49 00 5 Colorado Child Care Credit multiply the amount on line 3 by the percentage on line 4 50 If the total entered on line 49 of this Form 104CR exceeds the total of lines 15 and 16 Form 104 see the limitation at the bottom of this form Credits to be carried forward to 2012: LIMITATION: The total credits you claim on line 49 of this Form 104CR are non refundable credits so the total credits used may not exceed the total tax reported on lines 15 and 16 of your income tax return Form 104 Most unused 2011 credits can be carried forward to tax year 2012 If the total credits available exceed the total tax due for 2011 or if you are carrying forward credits that cannot be used in 2011 list the credit type(s) and excess amount(s) on line 50 6 Part year residents only: Enter the percentage from line 34 Form 104PN % (cannot exceed 100%) Multiply this percentage by the amount on line 5 6 US GOVERNMENT INTEREST 7 List eligible child s name date of birth and Social Security number if a credit is claimed on lines 5 or 6 7 PRIMARY TAXPAYER PENSION/ANNUITY income (Beneficiaries list deceased s SSN: ) 8 Refundable alternative fuel vehicle credit 8 SPOUSE PENSION/ANNUITY income if any (Beneficiaries list deceased s SSN: ) 9 COLORADO SOURCE CAPITAL GAIN 5 year assets acquired on or after 5/9/1994 9 Enter income from line 8 that is from State of Colorado unemployment benefits; and/or is from another state s benefits that were received while you were a 9 Total refundable credits; add lines 5 or 6 and 8 Enter here and on line 23 Form 104 9 a Colorado resident (See A federal net operating loss carried back to a tax year beginning on or after January 1 1987 or carried forward will be allowed for Colorado income tax purposes A nonresident or a part year resident may carry back or forward that portion of his federal net operating loss that is from Colorado sources or which relates to the Colorado portion of the year Additional tax due total of lines 30 and 31 AdditionstoAdjustedGrossIncome Entertheamountfromline3ofColoradoForm After completing the Amended Colorado Income Tax Return file it with a computer smartphone or tablet using our free and secure Revenue Online service at www Colorado gov/RevenueOnline By filing your return electronically you significantly reduce the chance of errors If you cannot file electronically for any reason mail the following form AMENDED amount on line 29 33 Amount on line 33 divided by the amount on line 32 34 AMOUNT OWED Lines 30 through 36 Compute the amount owed to the state on the amended return Any decrease in the amount of the overpayment (line 30) or increase in the amount owed (line 31) will indicate that an amount is owed with the amended return If you have any unpaid balance from your original return the amount calculated on line 36 will be added to your delinquency Or if a refund was issued with the original return you may receive an assessment that requires repayment of your refund to the state Amount you want credited to 2012 estimated tax and/or any lump sum distribution from a pension or profit sharing plan received while Apportioned tax Amount on line 35 multiplied by the percentage on line 34 Enter here and on Form 104 line 15 36 AS AMENDED as follows: as instructed Attachments: Be sure to refer to the 104 Booklet to see which attachments are required for your tax situation You must attach all required documentation to this return EVEN IF YOU ATTACHED IT TO YOUR ORIGINAL RETURN All attachments and certifications must be included with the amended return even if there is no change to that credit or tax attribute Part year residents and nonresidents attach corrected Form 104PN If this amended return is the result of an adjustment made by the Internal Revenue Service attach a copy of the federal revenue agent s report with supporting schedules To expedite your refund submit a copy of the federal record of account to support any changes to federal taxable income (such as a mutual fund brokerage firm or credit union) CALCULATE YOUR TAX: FULL YEAR RESIDENTS TURN TO PAGE 22 PART YEAR RESIDENTS AND NONRESIDENTS GO TO 104PN Change in filing status: Check the federal form you filed: Check whether this vehicle was purchased: New Check whether this vehicle was: Leased Child s Name Date of Birth Social Security Number Child s Name Date of Birth Social Security Number Colorado Department of Revenue COLORADO DEPARTMENT OF REVENUE DENVER CO 80261 0005 COLORADO INCOME TAX WITHHELD from W 2 and 1099 statements 21 Colorado resident Colorado resident and/or was earned from a Colorado operation Colorado residents Claimed a federal child care credit for a child 12 or younger COLORADO TAXABLE INCOME line 4 minus line 13 ColoradoAdjustedGrossIncome IfyoufiledForm1040or1040A subtractthe amount on line 23 of Form 104PN from the amount on line 21 of Form 104PN If you filed Form 1040EZ enter the total of lines 5 7 and 9 of Form 104PN 25 Complete the direct deposit information if you want your refund deposited directly into your account at a United States bank or other financial institution Complete the return with the corrected amounts as amended COMPUTE THE AMOUNT OWED COMPUTE THE REFUND Dealership Name DECEASED Deceased taxpayer: Denver CO 80261 0005 Department Use Only Did this vehicle permanently displace a power source from Colorado that was 10 years old or older? Yes Direct Deposit: Domestic production activities deduction is allowed in the Colorado to Federal QPAI ratio DPSRS contributions made in 1986; Email Address Enter all income from Form 1040 line 19; Form 1040A line 13; or Form 1040EZ line 3 Enter all income from Form 1040 line 7; 1040A line 7; or Form 1040EZ line1 Enter all interest/dividend income from Form 1040 lines 8a and 9a; Form 1040A lines 8a and 9a; or Form 1040EZ line 2 Enter income from line 4 that was earned while working in Colorado and/or earned while you were a Colorado resident Part year residents should include moving expense reimbursements only if paid for moving into Colorado Enter income from line 6 that was earned while you were a resident of Colorado ESTIMATED TAX enter the sum of payments and credits and amounts withheld from nonresident real estate sales and partnership/S corp/fiduciary income 22 FEDERAL ADJUSTED GROSS INCOME from your federal income tax return: 1040EZ line 4; 1040A line 21; 1040 line 37 25 Federal adjusted gross income is $60 000 or less See FYI 33 for more information Federal Colorado Federal net capital loss carryback from tax year ending Protective claim attach explanation File this form now through Revenue Online Visit www Colorado gov/RevenueOnline today! File using Revenue Online and enter Direct Deposit information to get your refund in half the time! For treatment of other adjustments reported on form 1040 line 36 see For treatment of other subtractions see Foreign Address: Form 104 excluding any qualifying charitable contributions FORM 104CR INDIVIDUAL CREDIT SCHEDULE 2011 FORM 104PN PART YEAR RESIDENT/NONRESIDENT TAX CAlCulATION SCHEDulE 2011 FORM 104X (12/30/11) FORM 104X INSTRUCTIONS from non Colorado state or local bond interest earned while a Colorado resident If the amended return is being filed to change the filing status from joint to single or married separate the taxpayer whose SSN was listed first on the joint return should include all applicable tax data in their amended return The taxpayer whose SSN was listed second on the joint return must have an explanation that specifies the original return was filed under a different primary SSN If the amended return is being filed to change the filing status from single or married separate to joint the taxpayer that filed the single return must be listed first on the amended return If both taxpayers have filed single then either taxpayer can be listed first and the explanation must specify that one of the original returns was filed under a different primary Social Security Number (SSN) If the taxpayer died since the original return was filed and you are requesting a refund submit a copy of DR 0102 Claim for Refund Due Deceased Taxpayer and a copy of the death certificate Check the deceased box after the decedent s name If this amended return is being filed to keep the statute of limitations open pending the outcome of a court case or tax determination in another state that affects your Colorado return check the protective claim box under reason for filing corrected return If you are entering an address for a foreign country use the State field for the foreign country and enter the foreign postal code in the ZIP Code field A Province may be included in the City field with If you filed federal Form 1040A go to line 20 If you filed Form 1040 continue with line 14 If you filed federal Form 1040EZ go to line 24 All others continue with line 10 If you want the Department of Revenue to compute and mail your refund or compute your balance due and mail a bill stop hereand leave lines 26 through 41 blank If you want to compute the refund or balance due yourself continue with line 26 in the Colorado to federal total income ratio (line 21/ line 20) in the ratio of Colorado wages and/or self employment income to total wages and/or in the United States Income 6 Income 6 for treatment of other additions) Information Information Interest rates on additional amounts due are as follows: January 1 through December 31 2012 LAST NAME FIRST NAME AND INITIAL YourselfSpouse if jointMailing Address City State ZIP Code Changing filing status Changing residency status Line 27 minus line 26 but not less than zero 30 Line 28 minus line 29 but not less than zero 31 Mail and make checks payable to: Model More Than: But Not More Than: Moving expenses if you are moving into Colorado not if you are moving out NET TAX subtract line 19 from line 18 20 NON REFUNDABLE CREDITS from 104CR line 49 cannot exceed the sum of lines 15 + 16 19 Nonresident 305 day rule Military Note: Fill in forms are not saveable and will not file the return for you You must print the return and mail it We recommend you file through Revenue Online Return to the Form Web page and click on eFile on line 28 32 Overpayment total of lines 37 and 38 39 Owner s SSN (see instructions) Paid Preparer s Address Paid Preparer s Name Paid Preparer s Telephone Part I Colorado Child Care Credit Part II Other Refundable Credits Part V Other Credits Column(a) Column(b) Pay online at www Colorado gov/RevenueOnline or see instructions for other payment options Penalty paid on early withdrawals made while a Colorado resident Please note: This file includes related forms and schedules Even when there is no change to a schedule or any other related form those forms must be completed again (or you must include copies submitted with the original return) Also attach other schedules or credit certifications to the amended return even if copies were attached to the original return Failure to attach these documents may result in processing delays Avoid these delays by filing through Revenue Online Protective Claims: qualified reservation income REFUND AMOUNT Lines 37 through 41 Compute the amount of credit available on the amended return Any increase in the amount of the overpayment (line 37) or decrease in the amount owed (line 38) will indicate that an overpayment is available on the amended return The overpayment can be credited to estimated tax (line 40) for the following tax period or can be requested as a refund (line 41) If you previously paid additional tax with your original return the full refund amount shall consider this Or if you received a higher refund amount on your original return you may in fact now owe the state REFUNDABLE CREDITS from 104CR line 9 23 Required Information: Submit a copy of the invoice and proof of Colorado registration when claiming this credit retirement subtraction to the extent included on line 13 above RETURN ROUND ALL DOLLAR AMOUNTS TO THE NEAREST DOLLAR schedule A (see instructions) Scroll down to view your form self employment income SIGN YOUR Social Security Number Spouse is (check one): Spouse s Signature If joint return BOTH must sign STAPLE W 2 W 2G AND1099 FORMS HERE STATE INCOME TAX REFUND enter the state income tax refund from line 10 of your federal 1040 Statute of limitations: Subtotal add lines 1 through 3 4 SUBTRACTIONS Subtotal add lines 15 through 17 18 Subtotal add lines 21 through 23 24 Subtotal add lines 5 through 12 13 Tax due paid after 30 days of billing 6% Tax due paid without billing or paid within 30 days of billing 3% Tax from the tax table based on income reported on Colorado Form 104 line 14 35 TAX PREPAYMENTS AND CREDITS Taxpayer is (check one): Taxpayer s Name Taxpayer s Name Social Security Number the city The federal interest subtraction to the extent included on line 7 above the individual income tax return you already filed for the specific tax year Please refer to the 104 Booklet for line by line instructions and details about specific additions subtractions and tax credits The state income tax refund subtraction to the extent included on line 19 above 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 funds the Department of Revenue may collect the payment amount directly from your bank account electronically The statute of limitations for filing a Colorado claim for refund is generally four years from the original due date of the return or three years from the date of last payment of tax for the year involved whichever is later The statute of limitations for claiming a refund that is the result of a loss carry back or an investment tax credit carry back is four years from the due date of the return for the year in which the loss or credit originated See FYI General 18 Thepension/annuitysubtractionandthePERAorSchoolDistrictNumberOne tier I or II railroad benefits; To submit required documentation attach the documentation to your e filed return (if your software allows) or go to Revenue Online at www Colorado gov/RevenueOnline to electronically send a PDF If you do not have access to the technology to electronically submit the information you must mail the required documentation with the DR 1778 Total Colorado Income Enter the total from the Colorado column lines 5 7 9 11 Total Contributions $ TotalIncome EnteramountfromForm1040line22;orForm1040Aline15 20 Under penalties of perjury I declare that to the best of my knowledge and belief this return is true correct and complete Use Form 104X Amended Colorado Income Tax Return to correct Use this form if you and/or your spouse were a resident of another state for all or part of 2011 This form apportions your gross income so the Colorado tax computed from the tax table on your total 2011 income will be reduced to reflect only the tax on your Colorado income Complete this form after you have filled out lines 1 through 14 of Form 104 If you filed federal form 1040NR see Income 6 and for military service persons Income 21 Vehicle Make WE STRONGLY RECOMMEND THAT YOU FILE USING REVENUE ONLINE; IF YOU CANNOT EFILE YOU MAY MAIL TO: Who qualifies for this credit? Year of Birth Your Federal Adjusted Gross Income Your Percentage Your Signature Your telephone number