Form Dr 0594 - Renewal Application For Sales Tax License - Colorado Department Of Revenue
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1
2DR 0594 (06/16/15)
*150594==19999*
COLORADO DEPARTMENT OF REVENUE
Denver CO 80261-0013
Renewal Application for Sales Tax License
Date Received
Renewal Application License Period
(MMYY-MMYY)
Last Name
First Name
Middle Initial
Address
City
State Zip
Check If all business(es) sell cigarettes or tobacco products over the counter or by vending machine on their
premises.
Liability Information (Refer to Sales Tax License for Liability Information)
County / City / Industry
Activity
Type
Sales Tax License Number
Year Due
Notice Date
Total Fee(s) Owed
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.
$
.00
Address
City
State Zip
License Number
Liability—Source Trans
Fee
Address
City
State Zip
License Number
Liability—Source Trans
Fee
Address
City
State Zip
License Number
Liability—Source Trans
Fee
Address
City
State Zip
License Number
Liability—Source Trans
Fee
Address
City
State Zip
License Number
Liability—Source Trans
Fee
Address
City
State Zip
License Number
Liability—Source Trans
Fee
Signature of Applicant
Title
Date
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