Form Dr 0122 - International Fuel Tax Agreement Tax Report - Colorado Department Of Revenue
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2DR 0122 (07/08/04)
Departmental use only
Print Form
COLORADO DEPARTMENT OF REVENUE
1375 SHERMAN STREET
DENVER CO 80261-0016
INTERNATIONAL FUEL TAX AGREEMENT TAX REPORT
Return this Copy
Make a copy for your record
Colorado Account Number
IFTA Account No. (FEIN or SSN)
Period
Due Date
5600-100
A. Total miles traveled in all jurisdictions
B. Total fuel consumed in all jurisdictions
C. Average miles per gallon
2. Fuel Type -
PLEASE SELECT FUEL TYPE BEFORE FILLING REMAINDER OF FORM
1. Diesel
2. LPG
3. Gasoline
4. Gasohol
5. LNG (Natural Gas)
6. CNG
7. Ethanol
8. Methanol
9. E-85
10. M-85
11. A55
IFTA TAX COMPUTATIONS (round to the nearest whole gallon and mile) - Continued on the Reverse Side
5.
7.
8.
9.
3.
4.
6.
10.
11.
12.
Total
Tax
Net
Tax
Juris-
Total
Taxable
Tax
Interest
Total
Taxable
Paid
Taxable
Rate
diction
Miles
Gallons
(8x9)
Due
(10+11)
Miles
Gallons
Gallons
(per gallon)
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Parent category: Financial