Form 104bep - Colorado Nonresident Beneficiary Estimated Income Tax Payment Voucher - 2012

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FORM 104BEP (08/20/12)
FORM 104BEP Web (08/20/12)
COLORADO DEPARTMENT OF REVENUE
COLORADO DEPARTMENT OF REVENUE
Denver CO 80261-0008
Denver CO 80261-0008
2012 Colorado Nonresident Beneficiary
Estimated Income Tax Payment Voucher
Every fiduciary of an estate or trust, with a nonresident
income from sources within Colorado, in which case the
beneficiary who receives net income from real or tangible
fiduciary shall withhold and pay only the amount of tax
personal property within Colorado, shall withhold and pay
disclosed by the beneficiary’s return. Use Form 104BEP
taxes to the Department of Revenue out of the income
to make the payment. File Form 104BEP using the name,
to be distributed to such nonresident beneficiary. The
address and Social Security number of the beneficiary.
amount to be withheld is 4.63% of the beneficiary’s share
Photocopy additional copies of Form 104BEP as needed.
of said income, computed without exemption, unless the
.
Payment is due at the time the income is distributed
nonresident beneficiary files a timely return of his total
DETACH FORM
ON THIS LINE
Cut here and send only the coupon below. Help us save time and your tax dollars.
(0068)
2012 Colorado Nonresident Beneficiary
FORM 104BEP Web (08/20/12)
FORM 104BEP (08/20/12)
COLORADO DEPARTMENT OF REVENUE
COLORADO DEPARTMENT OF REVENUE
Estimated Income Tax Payment Voucher
Denver CO 80261-0008
Denver CO 80261-0008
70
Payment for Nonresident Beneficiary
For tax period ______________________, 2012, 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 “2012 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.
Amount of Payment
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.
(08)
$
.0 0
(Do not write in space below)

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