Form Dr 8453c - Corporate Income Tax Declaration For Electronic Filing - State Of Colorado
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1
2DR 8453C (10/17/13)
*138453C=19999*
COLORADO DEPARTMENT OF REVENUE
Denver, CO 80261-0006
State of Colorado Corporate Income Tax
Declaration for Electronic Filing
When feasible attach in PDF format to your e-filed return
Do not mail this form to the IRS or the Colorado Department of Revenue
Tax Year End
Retain with your records
Tax Year Beginning
(MM/DD/YY)
(MM/DD/YY)
Colorado Account Number
Business Name
Address
FEIN
City
State
ZIP
Phone Number
(
)
Part I—Tax Return Information
1. Total Income, from federal Form 1120
1 $
2. Federal Taxable Income from federal Form 1120
2 $
3. Colorado Tax, line 17 on Colorado Form 112
3 $
4. Colorado Payments, line 23 on Colorado Form 112
4 $
5. Amount You Owe, line 32 on Colorado Form 112
5 $
6. Refund, line 35 Colorado Form 112
6 $
Part II — Declaration of Tax Payer
Under penalties of perjury, I declare that I am an officer of the company listed above and the information provided for electronic
filing and the amounts shown in Part I above agree with the amounts shown on the company's 2013 Federal/Colorado income
tax returns, and that said tax returns, statements, schedules and attachments are true, correct, and complete to the best of my
knowledge and belief. I understand that I (or my Electronic Return Originator (ERO) if
applicable) may be required to provide paper copies of this declaration, my returns, withholding statements, schedules and
attachments upon request by the Colorado Department of Revenue at any time during the period covered by the Colorado
statute of limitations.
Signature
Date
Title
(MM/DD/YY)
Part III —Declaration of ERO/Preparer/Transmitter
If the transmitter did not prepare the tax return, check here
If I am not the preparer, I declare only that the amounts shown in Part I above agree with the amounts shown on the
taxpayer's 2013 Federal/ Colorado income tax returns. If I am the preparer, under penalties of perjury I declare that I
have reviewed the above taxpayer's 2013 Federal/Colorado income tax returns and that the information provided to me
by the taxpayer and the amounts shown in Part I above agree with the amounts shown on said tax returns, and that said
tax returns, statements, schedules, and attachments are true, correct, and complete to the best of my knowledge and
belief. As preparer, I further declare that I have obtained the taxpayer's signature on this form at the time of filing and have
provided the taxpayer with copies of all forms and information filed. I also agree to maintain this signed Form (DR 8453C)
for the period covered by the Colorado statute of limitations, and to provide paper copies of this declaration, said returns,
withholding statements, schedules, and attachments upon request by the Colorado Department of Revenue at any time
during this period.
ERO's Signature
Preparer Identification Number
or Your SSN
Date
(MM/DD/YY)
Check if also Preparer
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