Full-Year, Part-Year and Nonresident Individuals Colorado Individual Income Tax Filing Guide Mailing Address For Form DR 0104 104 BOOK 2021 Booklet Includes: Instructions | DR 0104 | Related Forms Tax.Colorado.gov { { This book includes: yy DR 0104 2021 Colorado Individual Income Tax Form yy DR 0104EE Colorado Easy Enrollment Information Form yy DR 0104CH 2021 Voluntary Contributions Schedule yy DR 0900 2021 Individual Income Tax Payment Form yy DR 0104AD 2021 Subtractions from Income Schedule yy DR 0158-I 2021 Extension Payment for Colorado Individual Income Tax yy DR 0104PN Part-Year Resident/Nonresident Tax Calculation Schedule 2021 yy DR 0104US 2021 Consumer Use Tax Reporting Schedule yy DR 0104CR Individual Credit Schedule 2021 yy DR 0347 Child Care Expenses Tax Credit yy Disclosure of Average Taxes Paid yy Colorado Income Tax Table yy Description of Voluntary Contribution organizations With Payment These addresses and zip codes are exclusive to the Colorado Department of Revenue, so a street address is not required. Colorado Department of Revenue Denver, CO 80261-0006 Colorado Department of Revenue Denver, CO 80261-0005 Without Payment (05/08/23)

Page 2 Disclosure of Colorado Expenditures and Revenues Expenditures by Function Revenues by Source ** Due to rounding, the values in each chart may not sum to 100% Disclosure of Average Taxes Paid.............................. 2 Using this Guide: Filing Instructions........................... 3 Taxpayer Service and Assistance.............................. 9 Tax Table.................................................................. 17 DR 0104: Colorado Return for All Resident Types...... 19 DR 0104EE: Colorado Easy Enrollment Information Form....................................................... 23 DR 0104CH: Voluntary Contributions Schedule....... 25 DR 0104AD: Subtractions from Income Schedule... 27 DR 0900: Individual Payment Form......................... 29 DR 0158-I: Extension Information and Form............ 31 DR 0104PN: Part–Year Resident/Nonresident Tax Calculation Schedule......................................... 33 DR 0104US: Consumer Use Tax Reporting Schedule................................................. 37 DR 0104CR: Individual Credit Schedule.................. 39 DR 0347: Child Care Expenses Tax Credit.............. 45 Voluntary Contribution Information........................... 47 Table of Contents Disclosure of Average Taxes Paid by Income Group - 2018 $0 to $15,000 1 $15,000 to $29,999 $30,000 to $39,999 $40,000 to $49,999 $50,000 to $69,999 $70,000 to $99,999 $100,000 to $149,999 $150,000 to $199,999 $200,000 and more Average 2 Average State Taxes Paid Individual Income $90 $319 $762 $1,139 $1,667 $2,557 $4,040 $6,028 $18,136 $3,706 Sales and Use $329 $348 $507 $511 $580 $728 $939 $1,168 $2,704 $850 Gasoline $91 $99 $138 $154 $172 $203 $245 $264 $450 $201 Driver License and Vehicle Registration Fees $81 $111 $141 $149 $157 $179 $202 $217 $233 $164 Alcoholic Beverages $4 $3 $5 $6 $8 $9 $14 $18 $54 $13 Cigarettes and Tobacco $53 $48 $51 $58 $56 $58 $50 $41 $51 $52 Total State Taxes $648 $927 $1,605 $2,018 $2,640 $3,734 $5,490 $7,737 $21,629 $4,986 Average Local Taxes Paid Residential Real Property $839 $1,061 $1,326 $1,431 $1,629 $2,159 $3,139 $4,368 $12,597 $3,069 Sales and Use $525 $554 $807 $815 $925 $1,160 $1,496 $1,861 $4,308 $1,354 Specific Ownership 3 $114 $165 $215 $228 $241 $279 $317 $342 $368 $253 Occupational Privilege 4 $2 $5 $8 $10 $13 $18 $26 $37 $115 $25 Total Local Taxes $1,480 $1,784 $2,357 $2,484 $2,807 $3,617 $4,977 $6,609 $17,388 $4,701 Average Federal Taxes Paid Individual Income $621 $1,089 $2,005 $2,957 $4,592 $7,608 $12,856 $21,817 $95,989 $15,779 Medicare $115 $273 $423 $546 $722 $1,003 $1,433 $1,951 $3,599 $1,091 Social Security $493 $1,165 $1,807 $2,333 $3,086 $4,287 $6,128 $8,344 $9,636 $4,058 Total Federal Taxes $1,230 $2,527 $4,235 $5,836 $8,399 $12,897 $20,417 $32,113 $109,224 $20,928 Average Total Taxes Paid $3,357 $5,239 $8,197 $10,337 $13,846 $20,248 $30,885 $46,459 $148,240 $30,614 Average Total Taxes Paid by Employers 5 $441 $1,181 $1,988 $2,606 $3,466 $4,825 $6,920 $9,357 $11,050 $4,555 Sources: Colorado and Federal income tax return data and the Bureau of Labor Statistics’ Consumer Expenditure Survey (CES) Note: The values presented in this table are estimates because actual values are not known. Income and taxes paid were estimated using Colorado, federal, and third party data sources. The population is limited to full-year resident Colorado households that filed 2017 state and federal income tax returns. Income includes taxable and nontaxable income as well as transfer payments (such as public assistance, supplemental security income, and nutrition assistance). 1 Households estimated to have negative income are excluded from this table because we cannot estimate their taxes paid. Negative income is associated with self- employment, investment losses, and other losses. 2 The Average represents the total taxes paid divided by the total number of income tax returns. The Average was calculated for each row by multiplying the average tax paid for each income group by the number of returns in that income group, and then summing those values together and dividing by the total number of returns. 3 Specific ownership taxes are local property taxes on motor vehicles. 4 The occupational privilege tax is also known as the “head” tax. 5 Employers pay taxes to Medicare and Social Security on the employees’ behalf. This is distinct from the Medicare and Social Security taxes paid by individuals. Other 2.4% Taxes 32.9% Interest & Rents 2.1% Charges for Goods & Services 14.4% Federal Grants & Contracts 46.0% License, Permits & Fines 2.2% Other 8.1% Education 28.3% Justice 4.8% Transportation 3.8% Business, Community & Consumer Affairs 24.3% Social Assistance 30.6%

Page 3 How To Use This Filing Guide This filing guide will assist you with completing your Colorado Income Tax Return. Please read through this guide before starting your return. Once you finish the form, file it with a computer, smartphone or tablet using our free and secure Revenue Online service at Colorado.gov/RevenueOnline. You may also file using private e-File software or with a paid tax preparer. You significantly reduce the chance of errors by filing your return electronically. If you cannot file electroni­ cally for any reason, mail the enclosed forms as instructed. All Colorado forms and publications referenced in this guide are available for download at Tax.Colorado.gov, the official Taxation website. The following symbols appear throughout this guide and point out important information, reminders and changes to tax rules.

This points out a topic that is the source of common filing errors. Filing your return on Revenue Online will reduce the risk of errors; however, it is important to understand the information on your return. Errors cause processing delays and erroneous bills.

Several subtractions and tax credits require you to provide supporting documentation. This symbol points out those requirements. If the additional documentation is not provided, it will cause processing delays or denial of the credits/ subtractions. These documents can be scanned and attached to your electronic filing through Revenue Online or most tax software, mailed with the DR 1778 or included with your paper return.

In-depth tax information is available in our easy to understand guidance publications, which include examples and worksheets. This symbol lets you know when such a publication is available for a subject. All guidance publications are available in the Tax Policy and Research section at Tax.Colorado.gov. Filing Information Who Must File This Tax Return Each year you must evaluate if you should file a Colorado income tax return. Generally, you must file this return if you are required to file a federal income tax return with the IRS for this year or will have a Colorado income tax liability for this year and you are: • A full-year resident of Colorado, or • A part-year Colorado resident who received taxable income while residing here (you must file the DR 0104 along with the DR 0104PN), or • Not a resident of Colorado, but received income from sources within Colorado (you must file the DR 0104 along with the DR 0104PN).

Colorado residents must file this return if they are required to file an income tax return with the IRS, even if they do not have a Colorado tax liability. Otherwise, the Department may file a return on your behalf and our return might not consider your unique tax situation. Also, the only way to determine if you are entitled to a refund is to file a return. Due Date The DR 0104 and any tax payment owed are due April 15, 2022. Revenue Online will accept returns as timely filed until midnight. Returns that are mailed must be postmarked by April 15. An automatic extension to file is granted until October 15, but there is no extension to pay. See page 31 for more information. If the due date falls on a weekend or federal holiday, return will be due the next business day. Deceased Persons Legal representatives and surviving spouses may file a return on behalf of a deceased person whose date of death was during the tax year. Surviving spouses may complete the return as usual and indicate the deceased status on the return. They can file the return and submit a copy of the death certificate through Revenue Online. Legal representatives may file the return and submit a copy of the death certificate through Revenue Online, but they must complete the Third Party Designee portion of the return. Either a surviving spouse or legal representative can avoid problems when filing on paper by marking the box next to the name of the deceased person, writing “DECEASED” in large letters in the white space above the tax year of the return, writing “FILING AS SURVIVING SPOUSE” or “FILING AS LEGAL REPRESENTATIVE” after their signature, and including the DR 0102 and a copy of the death certificate with the return.

To claim a refund on behalf of a deceased person: you must submit a copy of the death certificate with the DR 0102 when filing the return. Filing Status

You must file using the same filing status on both your federal and Colorado income tax returns. Any two individuals who legally file a joint federal income tax return must also file their Colorado income tax return jointly. Individuals filing a joint return must list the taxpayer names and Social Security numbers (SSN) in the same order on both the federal and Colorado returns. For married filing separately, do not list your spouse’s name or SSN on the return. Claiming Credits from a Pass-through Entity

Individuals claiming tax credits as a partner or shareholder must obtain from the partnership or S corporation a federal Schedule K-1 or other statement reporting the name and employer identification number (EIN) of the partnership or S corporation and the type and amount of the credit. The Colorado Department of Revenue verifies the credit claims of partners and shareholders by reviewing the partnership or S corporation’s return. The Schedule K-1s or statements may be submitted through Revenue Online, through tax software or may be included with a paper return.

Page 4 Line–by–Line Instructions for the DR 0104 First, complete the federal income tax return you will file with the IRS. You will use information from that return on your Colorado income tax return. Colorado income tax is based on your federal taxable income, which has already considered your deductions. Residency Status Mark the appropriate box to designate your residency status. If you are filing a joint return, and one person is a full-year Colorado resident and the other is either a part-year resident or a nonresident, mark the Part-Year Resident/Nonresident box. Part-Year Colorado Residents and Nonresidents Tax is prorated so that it is calculated only on income received in Colorado or from sources within Colorado. We recommend you review Income Tax Topics: Part-Year Residents & Nonresidents if this applies to you. You will calculate your prorated tax by completing the DR 0104PN. You must submit the DR 0104PN along with the DR 0104. Persons Traveling or Residing Abroad If you are traveling or residing outside the United States on April 15, the deadline for filing your return is June 15, 2022. If you need additional time to file your return, you will automatically have until October 15, 2022, to file. Interest is due on any tax paid after April 15, 2022. To avoid any late payment penalties, you must pay 90% of your tax liability by April 15, 2022, file your return by October 15, 2022 and pay any remaining tax due at the time of filing. If the due date falls on a weekend or federal holiday, return will be due the next business day. When filing your return, mark the “Abroad on Due Date” box on Revenue Online or the paper return. Active Duty Military Under federal law, a military servicemember’s state of legal residence does not change solely as the result of the service­ member’s assignment for service in another state. Consequently, a Colorado resident who enters into military service will remain a Colorado resident unless they officially change their state of legal residence as described in DD Form 2058. In general, military servicemembers who are Colorado residents are subject to the same income tax filing requirements as other Colorado residents, even if they are serving in another state. These requirements are described on the preceding page, under the heading “Who Must File This Tax Return.” However, any military servicemember who spends at least 305 days of the tax year stationed outside of the United States on active military duty may elect to be treated as a nonresident. The servicemember may make this election by filing a return and checking the applicable box on Form 104PN. Military servicemembers who are stationed in Colorado, but are not Colorado residents, are not required to pay Colorado tax on their military income. However, any other Colorado source income of a nonresident servicemember is subject to Colorado taxation. Please see Tax.Colorado.gov/military-servicemembers for additional information.

The residency rules described above for military servicemembers also apply generally to a servicemember’s spouse if the spouse is residing with the servicemember either inside or outside of Colorado in compliance with the servicemember’s military orders. If a servicemember and their spouse are nonresidents stationed in Colorado, any wages earned by the spouse for work performed in Colorado are not subject to Colorado taxation. The military spouse must complete a DR 1059, provide a copy to their employer when hired for employment, and submit a copy to the Department, along with a copy of their military ID card, when they file their Colorado return each year. The DR 1059 may be filed with the Department through Revenue Online, with DR 1778, or included with a DR 0104 filed by paper. Name and Address Provide your name, mailing address, date of birth, Social Security number and the state of issue, the last four digits, and the date of issuance of your state issued ID card in the provided spaces. If filing Married Filing Jointly, provide the spouse’s information where prompted. Provide the spouse’s information ONLY if filing a joint return. Otherwise leave blank. All Departmental correspondence will be mailed to the mailing address provided. We recommend you read publication FYI General 2 for the Privacy Act Notice. Colorado Health Coverage Easy Enrollment Colorado taxpayers can now share certain information from their state tax return with the Colorado Health Benefit Exchange (Connect for Health Colorado) and the Colorado Department of Health Care Policy & Financing to find out if they qualify for free or reduced-cost health coverage (Colorado Law: 39-21-113(25) C.R.S). If you give your permission, the Department of Revenue will share only the information on form DR 0104EE which includes: • Name and date of birth for you, your spouse, and everyone listed on your taxes as your dependent (your tax household). • Social Security Number or Tax ID for you, your spouse, and everyone listed on your taxes as your dependent. You may choose to not provide Social Security Numbers. • Your address, phone number, and email address so we can contact you. • Your income. • Whether you filed your return electronically or on paper. This information will only be used to check if you can enroll in health coverage and qualify for help paying for coverage. For more information about getting health coverage, visit Connect for Health Colorado at https://connectforhealthco.com. To see if you or members of your household qualify for free or reduced-cost health coverage, check this box if: • At least one person in your household does not have health coverage AND

Page 5 • You give permission for the Colorado Department of Revenue to share the information on Form DR 0104EE with Connect for Health Colorado (the Colorado Health Benefit Exchange) and the Department of Health Care Policy & Financing. To share your information, complete form DR 0104EE. If you are using software to complete your tax return, the software may autofill the form for you. Check it to make sure it is accurate and complete. If you are filing a paper return, complete the DR 0104EE and include it with your return. Line–by–Line Instructions for the DR 0104EE Section A: Household Contact Information Complete this information so Connect for Health Colorado can contact you to help you enroll in health coverage. Make sure your name, phone number, email address, and mailing address are correct and complete. Section B: Household Member and Income Information Complete this information so Connect for Health Colorado can check if you or members of your household qualify for free or reduced-cost health coverage. Your household includes yourself, your spouse, and any person that you claim as a tax dependent on your federal income tax return. Dependents are usually children who live with you but may include other relatives you support financially. Line 1: Enter your tax household size here. Include yourself, your spouse, and anyone you claim as a dependent on your federal income tax return. Line 2: Enter your adjusted gross income here. Adjusted gross income is found on line 11 of your federal tax form 1040, 1040-SR, or 1040-NR. Line 3: Enter information about yourself, your spouse, and/or dependents for each member of your tax household in the table below. Line 1 Federal Taxable Income Refer to your federal income tax return to complete this line: • Form 1040, 1040SR, 1040NR, or 1040SP line 15 If your federal taxable income is a negative amount, be sure to enter the amount as such on your Colorado return. If submitting a paper return, put the negative amount in parentheses, for example ($1,234).

Do not enter your total income or wages on this line because it will make your tax too high. The Department will compare the amount you list here to the return you file with the IRS, so be very careful to complete this correctly. Additions Line 2 State Addback Refer to your federal income tax return to complete this line. Enter $0 if you filed Form 1040, 1040SR, or 1040SP but did not itemize your deductions on Schedule A. Taxpayers who deduct general sales taxes on Schedule A line 5a, Form 1040, 1040SR, or 1040SP, are not required to calculate this addback. If you deducted state income tax on Schedule A line 5a, complete the worksheet below to calculate the Income Tax Deduction.

We recommend that you read the Individual Income Tax Guide for special instructions before completing the worksheet below. Complete the following worksheet to determine your state income tax deduction addback. a) Is the amount on federal 1040, 1040SR, or 1040SP Schedule A line 5d greater than the amount on federal Form 1040, 1040SR, or 1040SP Schedule A line 5e? $ No. Enter the state income tax deduction from federal Form 1040, 1040SR, or 1040SP Schedule A line 5a. Yes. Subtract the amounts on federal Form 1040, 1040SR, or 1040SP Schedule A lines 5b and 5c from the amount on line 5e. Enter the result, but not less than $0. b) Total itemized deductions from federal Form 1040, 1040SR, or 1040SP Schedule A line 17 $ c) The amount of federal standard deduction you could have claimed (See instructions federal Form 1040, 1040SR, or 1040SP line 12a for 2021 federal standard deductions.) $ d) Line (b) minus line (c), but not less than $0 $ Transfer to line 2 of the DR 0104 the smaller amount from line (a) or (d) of the worksheet above. Line 3 Qualified Business Income Deduction Addback Taxpayers who claimed a deduction for qualified business income under section 199A of the Internal Revenue Code are required to add to federal taxable income an amount equal to that deduction if the taxpayer’s adjusted gross income is greater than $500,000 ($1,000,000 if filing jointly). This addback does not apply to a taxpayer who is required to file a federal Schedule F, Profit or Loss From Farming, with their federal income tax return. Line 4 Other Additions Enter the sum of the following and specify which addition(s) in text box: • Bond interest—the amount of any interest earned from bonds issued by any state or political subdivision, excluding any bonds issued by the State of Colorado or its political subdivisions on or after May 1, 1980. Calculate the appropriate amount by subtracting the amortization of bond premiums and expenses (required to be allocated to interest income by Internal Revenue Code) from the gross amount of state and local bond interest. We recommend that you read the Individual Income Tax Guide if this applies to you.

Page 6 • Improper distributions from a qualified state tuition program for which tuition program contribution subtraction was previously claimed. See FYI Income 44 for additional information. • Charitable gross conservation easement—the amount of your federal charitable deduction for a conservation easement that is also claimed for a Colorado tax credit. Complete the DR 1305 Part D. • Alien labor—the amount of expenses for unauthorized alien labor services. We recommend that you read the Individual Income Tax Guide if this applies to you. • Partnership/Fiduciary—the amount of any fiduciary adjustment or partnership modification that increases your federal taxable income. • Any expenses incurred by a taxpayer with respect to expenditures made at, or payments made to, a club that restricts membership on the basis of sex, sexual orientation, marital status, race, creed, religion, color, ancestry or national origin. • Distributions from a medical savings account not made for an eligible expense. Line 5 Subtotal Enter the sum of lines 1 through 4. Line 6 Subtractions from the DR 0104AD Schedule, line 20 Transfer the amount from the DR 0104AD line 20 to report any subtractions from your Federal Taxable Income. These subtractions will change your Colorado Taxable Income from the amount of Federal Taxable Income. See instructions in the income tax booklet for additional guidance on completing this schedule. Do not enter negative amounts. To ensure faster processing of your paper return, the amount entered on line 6 must exactly match the amount on the DR 0104AD. You must submit the DR 0104AD with your return. Line 7 Colorado Taxable Income Subtract line 6 from line 5. This is your Colorado taxable income and is the figure used to determine how much Colorado tax is owed, if any. Part-Year Residents or Nonresidents Go To the DR 0104PN. Full-Year Residents Continue To Line 8 Line 8 Colorado Tax The income tax rate is currently 4.5%. Full-year residents should refer to the tax table in this booklet. Determine the tax by the amount listed on line 7. Part-year residents and nonresidents should transfer the apportioned tax amount from the DR 0104PN line 36. You must submit the DR 0104PN along with the DR 0104. Line 9 Alternative Minimum Tax Enter the amount of any Alternative Minimum Tax. Generally, if you pay alternative minimum tax on your federal income tax return, you will pay the same for your Colorado return. We recommend that you read the Individual Income Tax Guide if this applies to you. Line 10 Recapture of Prior Year Credits Enter any credit claimed in prior years that is subject to recapture under Colorado law. Line 11 Subtotal Sum of lines 8 through 10. Tax Credits Visit Tax.Colorado.gov/Income-Tax-Credits to read more about which tax credits can be claimed on this form. Line 12 Nonrefundable Credits Complete the DR 0104CR to claim various nonrefundable credits. Transfer the amount from the DR 0104CR line 43 to this line. The nonrefundable credits used from the DR 0104CR combined with the total Nonrefundable Enterprise Zone Credit used cannot exceed line 11. To ensure faster processing of your paper return, the amount entered on line 12 must exactly match the amount on the DR 0104CR. You must submit the DR 0104CR with your return.

Scan and submit any required documentation through Revenue Online E-Filer Attachment, attach to your electronic return or mail paper documentation with the DR 1778 E-Filer Attachment. Line 13 Nonrefundable Enterprise Zone Credits Use your tax software, Revenue Online or the DR 1366 to calculate the total amount of Nonrefundable Enterprise Zone Credits being used to offset the current year tax liability. Complete the DR 1366 and transfer line 84 to this line. The total Nonrefundable Enterprise Zone Credit used combined with nonrefundable credits from the DR 0104CR cannot exceed the amount on line 11. You must submit the DR 1366 and a copy of each certificate with your return.

The Department strongly recommends electronic filing for taxpayers with enterprise zone credits. Failure to file electronically may result in delays processing your return. Line 14 Strategic Capital Tax Credits Use your tax software, Revenue Online or the DR 1330 to calculate the total amount of nonrefundable Strategic Capital Tax Credits being used to offset the current year tax liability. Complete the DR 1330 and transfer amount on line 7b to this line. The total nonrefundable Strategic Capital Tax Credits used combined with nonrefundable credits from lines 12 and 13 cannot exceed the amount on line 11. You must submit the DR 1330 and a copy of each certificate with your return. The Department strongly recommends electronic filing for taxpayers with Strategic Capital Tax credits. Failure to file electronically may result in delays processing your return.

Please include a copy of each Strategic Capital Tax Credit Certificate Line 15 Net Income Tax Sum of lines 12, 13, and 14. Subtract that sum from line 11. This cannot be a negative number.

Page 7 Line 16 Use Tax Enter the amount from the DR 0104US schedule line 7. If you do not owe any use tax, then leave this line blank and DO NOT fill out the DR 0104US schedule. For more information on your consumer use tax obligation, including how to use the new annual customer reports from non-collecting retailers, please visit Tax.Colorado.gov/Consumer-Use-Tax. If you are reporting use tax on this return, you must submit the DR 0104US with your return. Line 17 Net Colorado Tax Sum of lines 15 and 16. Line 18 Colorado Income Tax Withheld Enter the sum of all Colorado income tax withheld as reported on W-2, W-2G and/or various 1099 statements.

Enclose your Colorado withholding forms where indicated or, if filing electronically, scan and submit them through Revenue Online E-Filer Attachments.

Failure to submit your withholding forms will result in the credit being denied. Do NOT include withholding for federal income tax, income tax from another state, or income tax from local governments. Be certain to exclude amounts withheld from Colorado real estate sales by nonresidents, nonresident beneficiary withholding, or Colorado partnership or S Corporation income withholding for nonresidents because these specified amounts should be listed on line 22. Line 19 Prior-year Estimated Tax Carryforward Enter the amount, if any, from your 2020 Colorado DR 0104 line 31. Line 20 Quarterly Estimated Payments Carefully review your payment(s) before completing this line. Use Revenue Online (Colorado.gov/RevenueOnline) to verify estimated taxes paid on your account. Doing so will reduce processing delays. Most taxpayers who have made quarterly estimated payments used the DR 0104EP to remit these payments. Refer to the Individual Income Tax Guide for more information about Estimated Payments. Line 21 Extension Payment Enter the amount, if any, you remitted with the DR 0158-I to ensure 90% of your tax was paid by the filing due date. Line 22 Other Prepayments Enter the sum of payments remitted on your behalf because you received Colorado income from: • an estate as a beneficiary – remitted using the DR 0104BEP, and/or • partnership or shareholder agreement–remitted using the DR 0108, and/or • a real estate transaction that closed during the tax year for which you are filing this return – remitted using the current DR 1079. Be sure to mark corresponding box(es) as appropriate. Line 23 Gross Conservation Easement Credit Complete all applicable parts of the DR 1305. Enter the amount from the DR 1305G line 33. You must submit the DR 1305G with your return. Line 24 Innovative Motor Vehicle and Innovative Truck Credit Complete one Form DR 0617 for each vehicle, truck, trailer, or modification claimed, then enter the amount (or sum) from each DR 0617 line 9 and/or line 18. You must submit each DR 0617 with your return. NOTE: If you assigned the credit to a financing entity you will not submit a Form DR 0617. For additional information, please refer to FYI Income 69.

For each Form DR 0617, you must also submit copies of the title, purchase invoice, lease agreement, or conversion receipts, along with proof of permanent Colorado registration for each vehicle for which you are claiming a credit. For financing entities that accept assignment of the credit, a completed Form DR 0618 must be submitted for each vehicle claimed. Line 25 Refundable Credits Complete the DR 0104CR to claim various refundable credits. Transfer the amount from the DR 0104CR line 9 to this line. You must submit the DR 0104CR with your return.

See the DR 0104CR for the required documentation for the credit claimed. Submit using Revenue Online, attach to an electronically filed return as a PDF or include with your paper return. Line 26 Subtotal Sum of lines 18 through 25. Lines 28 through 30 are only used to calculate your TABOR credit, they do not affect your Colorado tax liability. Line 27 Federal Adjusted Gross Income Refer to your 2021 federal income tax return to complete this line: • Form 1040, 1040SR, 1040NR, or 1040SP line 11 If your federal adjusted gross income is a negative amount, be sure to enter the amount as such on your Colorado return. If submitting a paper return, put the negative amount in parentheses, for example ($1,234). Line 28 Nontaxable Social Security Income Refer to your 2021 federal income tax return to complete this line. Subtract the amount on line 6b of Form 1040, 1040SR, or 1040SP from line 6a and enter that amount here. Line 29 Nontaxable Lump-sum Distributions from pension and profit sharing plans Refer to the DR 0104 line 4. If you entered any lump-sum distributions on line 4 that were reported to the IRS on federal form 4972, excluding any estate tax paid, enter the amount of lump-sum distributions here. Line 30 Nontaxable Interest Income from State and Local Bonds Refer to the DR 0104 line 4. If you entered any bond interest on line 4, enter the amount of bond interest income here. Line 31 Modified AGI for TABOR This line is automatically calculated by Revenue Online. If filing a paper return, enter the sum of lines 27 through 30.

Page 8 Line 32 State Sales Tax Refund Full-year Colorado residents who made their home in Colorado and were age 18 or older for the entire year of 2021 are eligible to receive the State Sales Tax Refund. Full-year residents who were under the age of 18 qualify for the refund only if they are required to file a Colorado return because of a federal requirement to file or to obtain a refund of wage withholding. Part-year and nonresidents do not qualify for this refund. Individuals incarcerated in either a Department of Corrections owned or operated facility or a county or municipal jail for 180 days may not be eligible for the refund. A person under the age of 18 who would have been convicted of a felony as an adult and committed to the Department of Human Services may not be eligible for the credit. In order to qualify, your return must be postmarked by April 15, 2022 or October 15, 2022 if you are filing an extension. If the due date falls on a weekend or federal holiday, your return must be postmarked by the next business day. To determine the credit available to you, refer to the amount you entered on line 31 and your filing status. Find the appropriate amount in the table that accompanies line 32 and enter the amount on line 32. Line 33 Sum of Lines 26 and 32 Enter the sum of line 26 (Subtotal) and line 32 (State Sales Tax Refund). Compare lines 17 and 33. If line 17 is greater, skip to line 37. If line 33 is greater, continue to line 34. Line 34 Overpayment Subtract line 17 from line 33. Line 35 Estimated Tax Carryforward Enter the amount, if any, you would like to be available for 2022 estimated tax. Line 36 Refund Subtract line 35 from line 34. This is the amount of your refund. You have the option of authorizing the Department to directly deposit these funds to your bank or CollegeInvest account. Otherwise, a refund check will be mailed to the address you have designated on this return. • Direct Deposit—Enter the routing and account numbers and account type. The routing number is 9 digits. Account numbers can be up to 17 characters (numbers and/or letters). Include hyphens, but do NOT enter spaces or special symbols. We recommend that you contact your financial institution to ensure you are using the correct information and that they will honor a direct deposit. See the sample check below to assist you in finding the account and routing numbers.

Did you know you can now direct deposit your tax refund into a new or existing CollegeInvest account? Please contact 1-800-448-2424 or visit CollegeInvest.org for more information. • Intercepted Refunds—The Department will intercept your refund if you owe back taxes or if you owe a balance to another Colorado government agency or the IRS. If you are filing a joint return and only one party is responsible for the unpaid debt, you may file a written claim to: Colorado Department of Revenue, Injured Spouse Desk, PO Box 17087, Denver, CO 80217-0087. Claims must include a copy of your federal income tax return, federal form 8379 and copies of all W-2, W-2G, or any 1099 statements received by both parties. DO NOT include your claim with this return. It will not be processed. Line 37 Net Tax Due Subtract line 33 from line 17. This is the amount you owe with this return. If you are filing after the due date (or valid extension) or you owe estimated tax penalty, continue to the next line. If you are filing timely and do not owe penalty or interest, go to line 41. Line 38 Delinquent Payment Penalty Calculate any penalty owed for delinquent filing or payment. The penalty is the greater of $5 or 5% of the net tax due for the first month after the due date and increased by 0.5% for each additional month past the due date. The maximum penalty is 12%. If you prefer not to calculate this penalty, the Department will bill you. Line 39 Delinquent Payment Interest Calculate any interest owed for delinquent filing or payment. The interest rate is 3% of the net tax due. If you prefer not to calculate this interest, the Department will bill you. Interest on any bill issued that remains unpaid after 30 days of issuance will increase to 6%. Line 40 Estimated Tax Penalty To calculate this penalty, complete the form DR 0204. Enter any estimated tax penalty owed on this line. You must submit the DR 0204 with your return. If you over compute your estimated tax penalty from what the Department calculates, any amount of overpayment of penalty will be refunded to you.

Scan and submit the form DR 0204 through Revenue Online E-Filer Attachments or submit the form with your paper return. Line 41 Amount You Owe Enter the sum of lines 37 through 40. Please note: Any assessment made by the Department will likely include delinquent payment penalty and interest. The only way to avoid paying penalty and interest is to pay in full by the filing due date. You have three payment options: • Pay Online—After submitting your return on Revenue Online, you will be given the opportunity to submit an online payment with your credit card, e-check or by Electronic Funds Transfer (EFT). A nominal processing fee may apply. If you file a paper return, you may still choose to pay electronically. Visit Colorado.gov/RevenueOnline for details.

Page 9 • Pay by Mail—If filing by Revenue Online or other electronic filing method and you wish to send a check or money order, complete the form DR 0900 and mail with your payment. Make payable to “Colorado Department of Revenue” and clearly write your Social Security number and “2021 DR 0104” on the memo line. Be sure to keep a copy of the money order or note the check number with your tax records. • Payment Plan—The Department will issue a bill for any unpaid balance due. When you receive the bill, you may set up a payment plan as instructed on the bill. Third Party Designee Mark the “Yes” box to appoint the person entered on your return as the designee to receive and inspect confidential tax information related to this tax return. If a firm or organization is listed, this tax information authorization will apply to any of its employees. The designee may: • call the Department for information about the return, including processing time and refund status; • request copies of notices, bills or transcripts related to the return; and • respond to inquiries regarding calculations and supporting documentation for the return. However, a designee cannot sign any form or protest, request any other change to the account, receive any refund, or otherwise represent or act on behalf of the taxpayer with the Colorado Department of Revenue. This authorization expires four years after the date the return is signed. A taxpayer may change or revoke it, or an appointee may withdraw from it. For more information, see the instructions for form DR 0145, Tax Information Authorization or Power of Attorney. W-2s and 1099s

When filing a paper return, all W-2s and/or 1099s that show Colorado income tax withholding must be included with the form. When filing an electronic return, attach scanned copies of all W-2s and/or 1099s that show Colorado income tax withholding to the e-filed tax return. If you are unable to attach W-2s and/or 1099s to your e-filed return, submit through Revenue Online, Colorado.gov/RevenueOnline. Taxpayer Service and Assistance Revenue Online and Secure Messaging The Department offers many services through Revenue Online. You can file or amend a return, submit required return attachments, monitor your account activity, pay taxes, check the status of a refund, file a protest and send a secure message to Department staff. Visit Colorado.gov/RevenueOnline to get started. Taxation Website Visit the official Colorado Department of Revenue’s Taxation Division website, Tax.Colorado.gov, for tax forms, guidance publications, education resources, legal research and more. Call Center Representatives are available Monday through Friday, 8 a.m. to 4:30 p.m. 303-238-SERV (7378) TTY/TDD 800-659-2656 Taxpayer Service Centers All visits for assistance and information can be scheduled at our webpage at Tax.Colorado.gov/Visit-a-Service-Center. Forms are available Monday through Friday, 8:00 am to 4:30 pm. For those who do not need assistance, each service center is equipped with a secure drop box for documents. Denver Metro—1881 Pierce Street, Entrance B, Lakewood, CO Colorado Springs—2447 North Union Boulevard Fort Collins—3030 South College Avenue Grand Junction—222 South 6th Street, Room 208 Pueblo—827 West 4th Street, Suite A

Page 10 Did Not Receive W-2 Statement from Your Employer • Contact your employer to request a copy, or • Use the year-to-date (YTD) Colorado wages and withholding amounts from your final paycheck stub to complete a Substitute W-2, form DR 0084. Submit both the final paycheck stub and DR 0084 with your return. Records Retention Keep all documentation you used to prepare your return at least 4 years after the due date, which is the statute of limitations for the Department to make changes to your return. However, if the Department does not receive your return, they may file on your behalf using the best information available. There is no statute of limitations for assessment if a return is not filed. Correcting Errors or Changing a Return Individual income tax returns from 2009 and forward may be amended electronically through Revenue Online. Filing and amending returns in Revenue Online is a free service. You may amend online even if the original return was filed on paper. Revenue Online has all the information from your original return. You will not need to re-enter everything. • If you cannot amend online, you may file the DR 0104X. Make sure you use the appropriate form version for the year you are amending. • If you are changing your Colorado return because the IRS made changes to your federal return, you must file the DR 0104X within 30 days of being notified by the IRS. You must amend your Colorado return in this case, even if there is no net change to your tax liability.

IT IS VERY IMPORTANT THAT YOU SUBMIT ALL SCHEDULES AND SUPPORTING DOCUMENTATION FOR ANY CHANGES WITH YOUR AMENDED RETURN. YOU MUST SUBMIT ALL SCHEDULES, EVEN IF YOU ARE NOT CHANGING THOSE VALUES. Estimated Tax Requirements If you expect next year’s Colorado tax liability to be greater than $1,000 after subtracting credits, you should make estimated tax payments using the DR 0104EP. We recommend that you read the Individual Income Tax Guide for additional information. Filing Errors and Incomplete Information It is important to read all the information available for your specific tax situation and to submit all required documentation with your return. Failure to do so may result in delayed processing of your return and refund, if any. We recommend that you file using Revenue Online to avoid common mathematical errors. You may also opt to use a commercial tax preparation software program or a paid tax professional to help you complete your return. Federal Earned Income Tax Credit and Colorado Insurance Programs Individuals with lower income and/or those who have qualifying children may be eligible for a refund resulting from the federal and/or state Earned Income Tax Credit (EITC), the federal Child Tax Credit, and/or low-cost health insurance through Child Health Plan Plus (CHP+). You may obtain additional information regarding the federal EITC online at IRS.gov or by calling Colorado United Way at 211. Additional information regarding CHP+ may be found at CCHP.org or by calling 1-800-359-1991. Common Issues

Page 11 If you use this schedule to claim any subtractions from your income, you must submit it with the DR 0104. Line 1 State Income Tax Refund Refer to your federal income tax return to complete this line. If you did not complete federal Schedule 1, Form 1040, 1040SR, 1040NR, or 1040SP, enter $0. Otherwise, enter the amount from line 1, Schedule 1, Form 1040, 1040SR, 1040NR, or 1040SP. Line 2 U.S. Government Interest Enter the sum of all interest earned from U.S. government bonds, treasury bills and other obligations of the U.S. or its territories, possessions and agencies that you reported on your federal income tax return and is calculated as part of your federal taxable income. We recommend that you read the Individual & Corporate Income Tax Guides if this applies to you.

Do not include interest earned from Federal National Mortgage Association and Government National Mortgage Association (Fannie Mae and Ginnie Mae). Dividends from mutual funds may not be 100% exempt. Line 3 Pension and Annuity Subtraction You might be eligible to subtract the income you earned from a pension or annuity. We recommend that you read publication FYI Income 25 if this applies to you. This subtraction is allowed only for pension or annuity income that is included in your federal taxable income. The amount of subtraction you can claim is also limited based upon your age. As of December 31, 2021, if you were: • Age 65 or older, then you are entitled to subtract $24,000 or the total amount of your taxable pension/ annuity income, whichever is smaller; or • At least 55 years old, but not yet 65, then you are entitled to subtract $20,000 or the total amount of your taxable pension/annuity income, whichever is smaller; or • Younger than 55 years old and you received pension/annuity income as a secondary beneficiary (widow, dependent child, etc.) due to the death of the person who earned the pension/annuity, then you are entitled to subtract $20,000 or the total amount of your secondary beneficiary taxable pension/annuity income, whichever is smaller. If this applies to you, please list the Social Security number of the deceased in the space provided.

Pension/annuity income should not be intermingled between spouses. Each spouse must meet the requirements for the subtraction separately and claim the subtraction only on their pension/annuity income. Any qualifying spouse pension/annuity income should be reported on line 4.

Submit copies of all 1099R and SSA-1099 statements with your return. Submit using Revenue Online or include with your paper return. Line 4 Spouse Pension and Annuity Subtraction If the secondary taxpayer listed on a jointly filed return is eligible for the pension and annuity subtraction, enter the qualifying amount on this line. Review the instructions for line 3 to see what amount qualifies. We recommend that you read publication FYI Income 25 if this applies to you.

Take precautions to report the subtraction on the correct line. The first person listed on the return shall report on line 3 and the second person listed shall report on line 4. Line 5 Military Retirement Subtraction You might be eligible to subtract the income you earned from your military retirement benefits. We recommend that you read publication Income Tax Topics: Military Servicemembers if this applies to you. This subtraction is allowed only for military retirement income that is included in your federal taxable income. To qualify, you must have been 54 years of age or younger as of December 31,2021. If you meet the age requirement, then you are entitled to subtract $10,000 or the total amount of your taxable military retirement benefits, whichever is smaller.

Military retirement benefits should not be intermingled between spouses. Each spouse must meet the requirements for the subtraction separately and claim the subtraction only on their military retirement benefits. Any qualifying spouse military retirement benefits should be reported on line 6.

Submit copies of all 1099R statements with your return. Submit as attachments when e-filing or using Revenue online, or include with your paper return. Line 6 Spouse Military Retirement Subtraction If the secondary taxpayer listed on a jointly filed return is eligible for the military retirement subtraction, enter the qualifying amount on this line. Review the instructions for line 5 to see what amount qualifies. We recommend that you read publication Income Tax Topics: Military Servicemembers if this applies to you.

Take precautions to report the subtraction on the correct line. The first person listed on the return must report on line 5 and the second person listed must report on line 6. Line 7 Colorado Capital Gain Subtraction You might be eligible to subtract some or all of the capital gain included in your federal taxable income, if the gain is derived from the sale of tangible personal property or from the sale of real property located in Colorado. The amount of this subtraction is limited to $100,000. We recommend that you read Income Tax Topics: Colorado Capital Gain Subtraction if this applies to you.

You must complete and submit the DR 1316 with your return. Take precaution to completely fill out each item of this form. Be as detailed as possible, especially when providing property descriptions, ownership, and dates of acquisition and sale. Line–by–Line Instructions for the DR 0104AD - Subtractions from Income Schedule

Page 12 Line 8 CollegeInvest Contribution Contributions to CollegeInvest can be deducted from your return. The contribution must have been included on your federal income tax return and calculated as part of your federal taxable income. We recommend that you read publication FYI Income 44 if this applies to you.

The three fields on line 8 should be left blank if the taxpayer and/or spouse are the CollegeInvest account owners who set up the account for the student beneficiary. If you are not the account owner (e.g. grandparent, friend), complete the three additional fields. To report contributions to more than one account, you must file electronically. Do not deduct contributions made to a tuition savings plan for another state or any tuition you paid while attending school.

Do NOT deduct contributions made by your employer/business to your College Invest account on this line. To claim pass-through credits for employer contributions to employee 529 qualified state tuition account, please refer to the instructions on form DR 0289 and report the credit on applicable credit schedule. Line 9 Qualifying Charitable Contributions Taxpayers who make charitable contributions that would be eligible for a federal income tax deduction, but do not claim federal itemized deductions on Schedule A of form 1040, 1040SR, 1040NR, or 1040SP, might be eligible to deduct a portion of their contribution on this form. We recommend that you read publication Income Tax Topics: Charitable Contributions if this applies to you. Use the worksheet on the next page to determine your qualifying contribution. (a) Did you itemize your deductions on Schedule A of federal form 1040, 1040SR, 1040NR, or 1040SP? Yes No (b) Did you deduct charitable contributions on the federal form? Yes No If you answered Yes on either (a) or (b) above, enter $0 on line 9; you do not qualify for this subtraction. If you answered No on both (a) and (b) above, continue below. (c) Enter the amount you could have deducted as charitable contributions on lines 11 and 12 of federal Schedule A (lines 2 and 3 on Schedule A of federal form 1040NR). $ (d) Colorado adjustment $500 (e) Subtract line (d) from line (c). This is the qualifying amount. If the amount is greater than $0, transfer to line 9. Enter the total contributions in the space provided and the subtraction after the $500 adjustment on line 9.

Do not enter an amount on this line if you already deducted your charitable donation on Schedule A of the federal form 1040, 1040SR, 1040NR, or 1040SP. Otherwise, you will be issued an assessment that will likely include penalty and interest.

For claims greater than $5,000, submit the receipts you received at the time of donation. For in-kind donations, submit an itemized list of the donated items and their fair market value. Submit using Revenue Online or include with your paper return. Do not send receipts of items that were purchased for donation. Line 10 Qualified Reservation Income List any amount of income that was derived wholly from reservation sources by an enrolled tribal member who lives on the reservation, which was included as taxable income on the Federal income tax form.

Submit proof of tribal membership, residence, and source of income. This must be submitted every three years by taxpayers claiming this subtraction. Line 11 PERA/DPSRS Subtraction If you made contributions to PERA between July 1, 1984, and December 31, 1986, or to Denver Public Schools District No. 1 Retirement during 1986 and your 2021 federal taxable income includes pension income, see FYI Income 16 to determine if you can take a subtraction for any of your pension income.

Submit a copy of your previously taxed contribution. PERA statements can be obtained from Copera.org or by calling 1-800-759-7372. Submit using Revenue Online or include with your paper return.

Do not list the amount of contributions you made as an employee this past year. Line 12 Railroad Benefit List any railroad retirement benefits that you reported on your federal income tax return and is calculated as part of your federal taxable income. We recommend that you read publication FYI Income 25 if this applies to you.

Submit copies of all RRB-1099 and RRB-1099R Statements. Submit using Revenue Online or submit with your paper return. Line 13 Wildfire Mitigation Measures Enter the amount incurred in performing wildfire mitigation on your land, up to $2,500. We recommend that you read publication FYI Income 65 to properly calculate this subtraction.

Submit copies of receipts for qualified costs for wildfire mitigation for your property. Submit using Revenue Online or submit with your paper return. Line 14 Colorado Marijuana Business Deduction For Colorado-licensed marijuana businesses, list any expenditure that is eligible to be claimed as a federal income tax deduction but is disallowed by section 280E of the Internal Revenue Code because marijuana is a controlled substance under federal law. To calculate this deduction, you must create pro forma federal schedule(s) for Business Profit or Loss as if the federal government would have allowed the expenditures from the marijuana business. The Colorado deduction shall be the difference between the profit/loss as calculated on the

Page 13 ACTUAL schedule(s) filed with the federal return and the pro forma schedule(s) described above.

You must submit the pro forma schedule(s), the MED license number and the actual federal schedule(s) with your Colorado return when claiming this deduction. Submit using Revenue Online or submit with your paper return. Line 15 Nonresident Disaster Relief Worker Subtraction For nonresident individuals, enter the amount of compensation earned for performing disaster-related work in the state during a declared state disaster emergency and for the 60 days thereafter. Disaster-related work includes repairing, renovating, installing, building, or rendering services that relate to infrastructure that has been damaged, impaired, or destroyed by a declared state disaster emergency or providing emergency medical, firefighting, law enforcement, hazardous material, search and rescue, or other emergency service related to a state declared disaster emergency. Enter the executive order number(s) from the Colorado governor’s office that declared the state disaster emergency in format “D YYYY-###.”

This subtraction is only available to nonresident individuals. If you are a full-year resident of Colorado, you are not eligible for this subtraction. Line 16 Reacquisition of Colorado Residency During Active Duty Military Service Subtraction This subtraction is only allowed to military servicepersons who meet several requirements. In order to qualify for the subtraction the serviceperson must (1) have Colorado as his or her home of record, (2) after enlisting in the military, have acquired legal residency in a state other than Colorado, and (3) on or after January 1, 2016, have reacquired Colorado residency. A military serviceperson who meets these three requirements can claim a subtraction for any compensation included in his or her federal taxable income that he or she received for active duty service after reacquiring Colorado residency. In order to have acquired residency in another state, you must have: 1. been physically present in that state, 2. intended to make that state your permanent home, and 3. intended to abandon your previous state of legal residence. In order to reacquire residency in Colorado, you need not be physically present in Colorado, but you must intend to both make Colorado your permanent home and to abandon your previous state of legal residence. In order to claim this subtraction, a taxpayer must include with his or her return: (1) a military form showing Colorado as his or her home of record, (2) evidence of acquiring residency in another state, and (3) evidence of reacquiring residency in Colorado during the tax year. Evidence of acquiring residency in another state and reacquiring residency in Colorado must come in one of the following forms: 1. voter registration; 2. records reflecting the purchase of residential property or an unimproved residential lot; 3. motor vehicle titling and registration; 4. notification to your prior state of legal residence of your intention to change your state of legal residence; 5. preparation of a new last will and testament reflecting your state of legal residence. If you qualify for this subtraction, enter the amount of compensation received for active duty military service on line 16 and submit all required evidence of residency with your return. Line 17 First-time Home Buyer Savings Account Interest Deduction You must complete the DR 0350 and submit with your return if you are claiming this deduction. You may only deduct the amount of taxable interest and/or earnings on the qualified account in the tax year claimed. This deduction is subject to recapture. Line 18 Other Subtractions from Federal Taxable Income Enter the sum of all other allowable subtractions. For more information about what to enter on this line, see the Income Tax – Subtractions page on Tax.Colorado.gov.

Do not include amounts that were earned outside Colorado, net operating losses, K-1 adjustments, military income, wage adjustments, repayments for which IRC section 1341 credits were claimed, or donations made to the Military Family Relief Fund on this line. Include a clear explanation of the subtraction being claimed on your return. Line 19 Subtractions Allowed Under HB21-1002 Under HB21-1002, taxpayers may claim a subtraction for tax years commencing in 2021 in relation to certain retroactive provisions of the CARES Act. For complete instructions on how to calculate this subtraction, please see the CARES Act guidance publication available at Tax.Colorado.gov/individual-income-tax-guidance-publications. In general, the allowable subtraction is an aggregate amount, calculated in multiple steps, based on the taxpayer’s Colorado taxable income for each of the preceding tax years which were affected by the CARES Act. First, the taxpayer must calculate, for each tax year beginning before March 27, 2020, the difference between their Colorado taxable income based on Colorado law and the amount the taxpayer’s Colorado taxable income would have been had certain provisions of the CARES Act applied to that tax year. The difference amounts calculated for each year are then aggregated and combined with the sum of addbacks for the business interest expense deduction, excess business losses, and net operating losses, pursuant to C.R.S. 39-22-104(3)(l),(m), and (n), for any prior tax year. The subtraction applies only after all other subtractions provided for in C.R.S. 39-22-104(4) and is limited to $300,000. Any amount of the allowable subtraction the taxpayer may not claim for the tax year commencing during 2021 may be carried forward to subsequent tax years. See the Guidance Publication for thorough instructions on how to calculate and claim this subtraction. Line 20 Subtotal Enter the sum of lines 1 through 19.

Page 14 Instructions for form DR 0104US–Consumer Use Tax Reporting Schedule Was Colorado sales or use tax paid on purchases of tangible personal property that is used, stored, or consumed within Colorado? YES: Some purchases will have sales or use tax included. Check your invoices and receipts to see if sales tax was paid. If sales tax was paid on all of your purchases, no consumer use tax is due. DO NOT FILL OUT THIS FORM. NO: Some sellers, either inside or outside of Colorado, may not collect sales or use tax from customers on purchases. Total the amount of your 2021 purchases where no tax was paid. State and special district (if applicable) consumer use tax must be paid on your purchases. Lines 1–2 State Consumer Use Tax Enter the total amount of 2021 purchases where no state sales tax or use tax was paid on line 1. Multiply line 1 by 0.029 (for the Colorado state sales tax rate of 2.9%). Round this number to the nearest whole dollar to calculate your Colorado consumer use tax liability. Enter this number on line 2. Lines 3–6 Special District Use Tax Use the table below to determine if you lived within a special district(s) in 2021. Report the total amount of 2021 purchases where no special district tax was paid on line 3. Then, enter the Special District Consumer Use (SDCU) code based on you lived in 2021 on line 4. If no special districts apply, enter 00 in the SDCU code field on line 4 and skip to line 6. Enter the special district use tax rate on line 5. Multiply line 3 by line 5. Round this number to the nearest whole dollar and enter your special district use tax liability on line 6. If no special districts apply, enter $0. Line 7 Enter the sum of lines 2 and 6. Transfer this amount to DR 0104 line 16. Submit this schedule with the DR 0104. Special District Name and Boundaries Use Tax Rate SDCU Code No Special District N/A 00 Regional Transportation District (RTD) Only The Denver metropolitan area including all of Boulder, Denver, and Jefferson Counties, northern Douglas County, the western areas of Adams and Arapahoe Counties, most of Broomfield County, and small part of southwest Weld County. 0.010 10 Scientific & Cultural Facilities District (CD) Only The Denver metropolitan area including all areas of Adams, Arapahoe, Boulder, Broomfield, Denver, and Jefferson Counties. All of Douglas county EXCEPT the city limits of Castle Rock and Larkspur. 0.001 20 Regional Transportation District (RTD) and Scientific & Cultural Facilities District (CD) Overlap between the RTD and CD districts (see individual descriptions above.) 0.011 12 Pikes Peak Rural Transportation Authority El Paso County EXCEPT within the municipal limits of Calhan, Fountain, Monument, Palmer Lake, or the Colorado Springs Commercial Aeronautical Zone. Note - Any areas annexed into these municipalities after 2004 are included in the PPRTA. 0.010 30 South Platte Valley Regional Transportation Authority Within the city limits of Sterling. 0.001 50 Roaring Fork Transportation Authority Within the city limits of Glenwood Springs or Carbondale. 0.010 61 Roaring Fork Transportation Authority Within the city limits of Basalt or New Castle. 0.008 62 Roaring Fork Transportation Authority Areas of unincorporated Eagle County in the El Jebel area and outside the city limits of Carbondale. 0.006 63 Roaring Fork Transportation Authority Aspen and Snowmass Village city limits, unincorporated Pitkin County. 0.004 64 Special District Rates and Boundaries Table Reference publication DR 1002 at Tax.Colorado.gov, your county assessor’s office, or district maps for additional information to determine whether you live within the boundaries of the above special districts. Most residents of the Denver metropolitan area are within the district boundaries of both the Regional Transportation District (RTD) and the Scientific & Cultural Facilities District (CD).

Page 15 Instructions for Select Credits from the DR 0104CR

Note There are two credits that are available for the preservation of historic properties and structures. Each credit has a different certification process and is subject to different limitations and qualification requirements. Line 20 Historic Property Preservation Credit The carry forward of prior year Historic Property Preservation credit (§39-22-514, C.R.S.) must be claimed on line 20 of the DR 0104CR. For more information on this credit, review FYI Income 1. Lines 34-36 Preservation of Historic Structures Credit The Preservation of Historic Structures credit (§39-22- 514.5, C.R.S.) must be claimed on lines 34 through 36 of the DR 0104CR. For more information on this credit, review resources available online from the Colorado Office of Economic Development or from History Colorado. Lines 2 through 5 To Calculate the Colorado Earned Income Tax Credit (EITC) for SSN Filers on DR 0104CR: Line 2 Enter the amount of earned income calculated for your federal return. In order to calculate the value of your Federal earned income tax credit, you must determine the amount of earned income. You may use the Earned Income Credit Worksheet (EIC Worksheet) and the Earned Income Credit (EIC) Table in the instruction booklet for Federal Form 1040, 1040SR, or 1040SP or use the EITC Assistant Tool online: IRS.gov/Credits-&-Deductions/Individuals/Earned-In­ come-Tax-Credit/Use-the-EITC-Assistant. It is available in both English and Spanish. Line 3 The federal EITC you claimed Refer to the credit you entered on the Federal Form 1040.

• Enter the amount of line 27a from Federal Form 1040, 1040SR, or 1040SP on the Colorado Form DR 0104CR line 3. Table Instructions: If you have a qualifying child and you claimed the EITC on the Federal 1040, 1040SR, or 1040SP, you will need to identify that child or those children in this table. Enter each qualifying child’s last name, first name, year of birth and Social Security number. Only check the “Deceased” box for a qualifying child if the child was born and died in 2021 and was not assigned an SSN, you must submit a copy of the child’s birth certificate, death certificate, or hospital records showing a live birth with your return. Line 4 COEITC Multiply the amount you entered on line 3 by 0.1 to calculate your Colorado EITC. Line 5 If you are filing as a part-year resident ONLY Multiply the amount you entered on line 4 by the percentage on the DR 0104PN line 34. (If the percentage exceeds 100%, use 100%.) Enter the result on line 5. This is the portion of the Colorado EITC you are allowed. Line 1 Child Care Expenses Credit (DR 0347 and DR 0104CR Part I) Taxpayers who pay child care expenses during the year and whose Adjusted Gross Income is $60,000 or less may be able to claim a child care expenses credit. Use form DR 0347 to calculate this credit and submit it along with the form DR 0104CR. Line 6 Business Personal Property Credit for Individual Business Owners The income tax credit for business personal property taxes is limited to $18,000 of the actual value of your personal property that you paid tax on during 2021. This is different than real property, which is not eligible for this credit. If your actual value is less than $18,000, you can claim the total amount of the assessment you paid, and you must include the assessor’s statement(s) for which you are claiming the credit. To find your actual value, either look for it on your statement, or find your assessed value and divide it by 0.29. Actual Value = Assessed Value/0.29. If you own personal property whose actual value is above $18,000 for which you were assessed, you can only claim the assessment on the first $18,000 of the property in question. You will need to prorate your assessment with the following formula: 18,000 * assessment = allowable credit actual value For example, if your assessment was $2,000 for personal property tax paid in 2021, but your actual value was $25,000, you would be permitted to claim $1,440 (72% of the tax assessed or ($18,000/$25,000)*$2,000)).

Please include a copy of your property tax statement for property tax paid in 2021. Line 8 Expanded Colorado Earned Income Tax Credit for ITIN Filers If you could not claim a federal EITC only because you, your spouse, or your dependents have an Individual Taxpayer Iden­ tification Number (ITIN) or a Social Security Number (SSN) that is not valid for employment, then you may be able to claim a Colorado Earned Income Tax Credit (COEITC). If you were able to claim a federal EITC, but you were not able to include some of your dependents only because they have an ITIN or SSN that is not valid for employment, then you may be able to claim a higher COEITC. To determine your eligibility, complete the eligibility checklist on form DR 0104TN. If you are eligible, complete form DR 0104TN to calculate the credit. Enter the amount of your COEITC on line 8 of form DR 0104CR. Review the instructions on form DR 0104TN for more information. You must submit the DR 0104TN with your return.

Page 16 Line 38 Rural & Frontier Health Care Preceptor Credit In order to claim this credit, the taxpayer must: • Receive certification that the preceptor satisfied all requirements to receive the credit from the institution for which the preceptor teaches or from the regional AHEC office with jurisdiction over the area in which the preceptorship took place. This certification must be completed on the DR 0366. • Send an electronic copy of the completed certification (DR 0366) to the Department by email to dor_preceptor@state.co.us. • If the preceptor receives notification from the Department that the taxpayer is entitled to claim the credit, file a Colorado income tax return and claim the credit on the return. You must submit the DR 0366 with your return. Line 39 Retrofitting a Residence to Increase a Residence’s Visitability Credit An income tax credit is available to help people with an illness, impairment or disability retrofit their residence for greater accessibility and independence. Dependents and spouses are also eligible and allows for up to a $5,000 credit per person in the family with a disability. To claim the credit, you must have been issued a tax credit certificate from the Colorado Department of Local Affairs/Division of Housing. For more information about the application process, visit cdola.colorado.gov

Please provide a copy of your tax credit certificate(s) from the Department of Local Affairs/ Division of Housing when claiming this credit. Line 40 Credit for Employer Contributions to Employee 529 Plan Complete the DR 0289 and transfer over the amounts of credit available and used to the DR 0104CR. You must submit the DR 0289 with your return. Line 41 Credit for Employer Paid Leave of Absence for Live Organ Donation An income tax credit is available for employers who incurred expenses during the tax year by paying an employee during his or her leave of absence period (not to exceed ten working days or the hourly equivalent of ten working days per employee) for live organ donation and for the cost of temporary replacement help, if any, during an employee’s leave of absence period. The amount of credit allowed is 35% of eligible expenses, as defined in statute.(§39-22-540, C.R.S.). You may not claim a tax credit related to a leave of absence period for an employee who you pay $80,000 or more in wages during the income tax year. Review the instructions on form DR 0375 for more information. You must submit the DR 0375 with your return.

Page 17 2021 Colorado Income Tax Table with tax rate of 4.5% To find your tax from the table below, read down the taxable income column to the line containing your Colorado taxable income from DR 0104 line 7. Then read across to the tax column and enter this amount on DR 0104 line 8. Part-year residents and nonresidents, enter tax on DR 0104PN line 35. TAXABLE INCOME TAX Over But not over 0 10 0 10 30 1 30 50 2 50 75 3 75 100 4 100 200 7 200 300 11 300 400 16 400 500 20 500 600 25 600 700 29 700 800 34 800 900 38 900 1,000 43 1,000 1,100 47 1,100 1,200 52 1,200 1,300 56 1,300 1,400 61 1,400 1,500 65 1,500 1,600 70 1,600 1,700 74 1,700 1,800 79 1,800 1,900 83 1,900 2,000 88 2,000 2,100 92 2,100 2,200 97 2,200 2,300 101 2,300 2,400 106 2,400 2,500 110 2,500 2,600 115 2,600 2,700 119 2,700 2,800 124 2,800 2,900 128 2,900 3,000 133 3,000 3,100 137 3,100 3,200 142 3,200 3,300 146 3,300 3,400 151 3,400 3,500 155 3,500 3,600 160 3,600 3,700 164 3,700 3,800 169 3,800 3,900 173 3,900 4,000 178 4,000 4,100 182 4,100 4,200 187 4,200 4,300 191 4,300 4,400 196 4,400 4,500 200 4,500 4,600 205 TAXABLE INCOME TAX Over But not over 4,600 4,700 209 4,700 4,800 214 4,800 4,900 218 4,900 5,000 223 5,000 5,100 227 5,100 5,200 232 5,200 5,300 236 5,300 5,400 241 5,400 5,500 245 5,500 5,600 250 5,600 5,700 254 5,700 5,800 259 5,800 5,900 263 5,900 6,000 268 6,000 6,100 272 6,100 6,200 277 6,200 6,300 281 6,300 6,400 286 6,400 6,500 290 6,500 6,600 295 6,600 6,700 299 6,700 6,800 304 6,800 6,900 308 6,900 7,000 313 7,000 7,100 317 7,100 7,200 322 7,200 7,300 326 7,300 7,400 331 7,400 7,500 335 7,500 7,600 340 7,600 7,700 344 7,700 7,800 349 7,800 7,900 353 7,900 8,000 358 8,000 8,100 362 8,100 8,200 367 8,200 8,300 371 8,300 8,400 376 8,400 8,500 380 8,500 8,600 385 8,600 8,700 389 8,700 8,800 394 8,800 8,900 398 8,900 9,000 403 9,000 9,100 407 9,100 9,200 412 9,200 9,300 416 9,300 9,400 421 9,400 9,500 425 9,500 9,600 430 TAXABLE INCOME TAX Over But not over 9,600 9,700 434 9,700 9,800 439 9,800 9,900 443 9,900 10,000 448 10,000 10,100 452 10,100 10,200 457 10,200 10,300 461 10,300 10,400 466 10,400 10,500 470 10,500 10,600 475 10,600 10,700 479 10,700 10,800 484 10,800 10,900 488 10,900 11,000 493 11,000 11,100 497 11,100 11,200 502 11,200 11,300 506 11,300 11,400 511 11,400 11,500 515 11,500 11,600 520 11,600 11,700 524 11,700 11,800 529 11,800 11,900 533 11,900 12,000 538 12,000 12,100 542 12,100 12,200 547 12,200 12,300 551 12,300 12,400 556 12,400 12,500 560 12,500 12,600 565 12,600 12,700 569 12,700 12,800 574 12,800 12,900 578 12,900 13,000 583 13,000 13,100 587 13,100 13,200 592 13,200 13,300 596 13,300 13,400 601 13,400 13,500 605 13,500 13,600 610 13,600 13,700 614 13,700 13,800 619 13,800 13,900 623 13,900 14,000 628 14,000 14,100 632 14,100 14,200 637 14,200 14,300 641 14,300 14,400 646 14,400 14,500 650 14,500 14,600 655 14,600 14,700 659 14,700 14,800 664 14,800 14,900 668 14,900 15,000 673 15,000 15,100 677 TAXABLE INCOME TAX Over But not over 15,100 15,200 682 15,200 15,300 686 15,300 15,400 691 15,400 15,500 695 15,500 15,600 700 15,600 15,700 704 15,700 15,800 709 15,800 15,900 713 15,900 16,000 718 16,000 16,100 722 16,100 16,200 727 16,200 16,300 731 16,300 16,400 736 16,400 16,500 740 16,500 16,600 745 16,600 16,700 749 16,700 16,800 754 16,800 16,900 758 16,900 17,000 763 17,000 17,100 767 17,100 17,200 772 17,200 17,300 776 17,300 17,400 781 17,400 17,500 785 17,500 17,600 790 17,600 17,700 794 17,700 17,800 799 17,800 17,900 803 17,900 18,000 808 18,000 18,100 812 18,100 18,200 817 18,200 18,300 821 18,300 18,400 826 18,400 18,500 830 18,500 18,600 835 18,600 18,700 839 18,700 18,800 844 18,800 18,900 848 18,900 19,000 853 19,000 19,100 857 19,100 19,200 862 19,200 19,300 866 19,300 19,400 871 19,400 19,500 875 19,500 19,600 880 19,600 19,700 884 19,700 19,800 889 19,800 19,900 893 19,900 20,000 898 20,000 20,100 902 20,100 20,200 907 20,200 20,300 911 20,300 20,400 916 20,400 20,500 920 20,500 20,600 925 TAXABLE INCOME TAX Over But not over 20,600 20,700 929 20,700 20,800 934 20,800 20,900 938 20,900 21,000 943 21,000 21,100 947 21,100 21,200 952 21,200 21,300 956 21,300 21,400 961 21,400 21,500 965 21,500 21,600 970 21,600 21,700 974 21,700 21,800 979 21,800 21,900 983 21,900 22,000 988 22,000 22,100 992 22,100 22,200 997 22,200 22,300 1,001 22,300 22,400 1,006 22,400 22,500 1,010 22,500 22,600 1,015 22,600 22,700 1,019 22,700 22,800 1,024 22,800 22,900 1,028 22,900 23,000 1,033 23,000 23,100 1,037 23,100 23,200 1,042 23,200 23,300 1,046 23,300 23,400 1,051 23,400 23,500 1,055 23,500 23,600 1,060 23,600 23,700 1,064 23,700 23,800 1,069 23,800 23,900 1,073 23,900 24,000 1,078 24,000 24,100 1,082 24,100 24,200 1,087 24,200 24,300 1,091 24,300 24,400 1,096 24,400 24,500 1,100 24,500 24,600 1,105 24,600 24,700 1,109 24,700 24,800 1,114 24,800 24,900 1,118 24,900 25,000 1,123 25,000 25,100 1,127 25,100 25,200 1,132 25,200 25,300 1,136 25,300 25,400 1,141 25,400 25,500 1,145 25,500 25,600 1,150 25,600 25,700 1,154 25,700 25,800 1,159 25,800 25,900 1,163 25,900 26,000 1,168 26,000 26,100 1,172

Page 18 Worksheet for taxable incomes over $50,000 Colorado Taxable Income from Form 104 line 7 $ .00 Multiply by 4.5% X .045 Colorado Tax $ .00 Colorado Income Tax Table TAXABLE INCOME TAX Over But not over 26,100 26,200 1,177 26,200 26,300 1,181 26,300 26,400 1,186 26,400 26,500 1,190 26,500 26,600 1,195 26,600 26,700 1,199 26,700 26,800 1,204 26,800 26,900 1,208 26,900 27,000 1,213 27,000 27,100 1,217 27,100 27,200 1,222 27,200 27,300 1,226 27,300 27,400 1,231 27,400 27,500 1,235 27,500 27,600 1,240 27,600 27,700 1,244 27,700 27,800 1,249 27,800 27,900 1,253 27,900 28,000 1,258 28,000 28,100 1,262 28,100 28,200 1,267 28,200 28,300 1,271 28,300 28,400 1,276 28,400 28,500 1,280 28,500 28,600 1,285 28,600 28,700 1,289 28,700 28,800 1,294 28,800 28,900 1,298 28,900 29,000 1,303 29,000 29,100 1,307 29,100 29,200 1,312 29,200 29,300 1,316 29,300 29,400 1,321 29,400 29,500 1,325 29,500 29,600 1,330 29,600 29,700 1,334 29,700 29,800 1,339 29,800 29,900 1,343 29,900 30,000 1,348 30,000 30,100 1,352 30,100 30,200 1,357 30,200 30,300 1,361 30,300 30,400 1,366 30,400 30,500 1,370 30,500 30,600 1,375 30,600 30,700 1,379 30,700 30,800 1,384 30,800 30,900 1,388 30,900 31,000 1,393 31,000 31,100 1,397 31,100 31,200 1,402 31,200 31,300 1,406 31,300 31,400 1,411 31,400 31,500 1,415 31,500 31,600 1,420 TAXABLE INCOME TAX Over But not over 31,600 31,700 1,424 31,700 31,800 1,429 31,800 31,900 1,433 31,900 32,000 1,438 32,000 32,100 1,442 32,100 32,200 1,447 32,200 32,300 1,451 32,300 32,400 1,456 32,400 32,500 1,460 32,500 32,600 1,465 32,600 32,700 1,469 32,700 32,800 1,474 32,800 32,900 1,478 32,900 33,000 1,483 33,000 33,100 1,487 33,100 33,200 1,492 33,200 33,300 1,496 33,300 33,400 1,501 33,400 33,500 1,505 33,500 33,600 1,510 33,600 33,700 1,514 33,700 33,800 1,519 33,800 33,900 1,523 33,900 34,000 1,528 34,000 34,100 1,532 34,100 34,200 1,537 34,200 34,300 1,541 34,300 34,400 1,546 34,400 34,500 1,550 34,500 34,600 1,555 34,600 34,700 1,559 34,700 34,800 1,564 34,800 34,900 1,568 34,900 35,000 1,573 35,000 35,100 1,577 35,100 35,200 1,582 35,200 35,300 1,586 35,300 35,400 1,591 35,400 35,500 1,595 35,500 35,600 1,600 35,600 35,700 1,604 35,700 35,800 1,609 35,800 35,900 1,613 35,900 36,000 1,618 36,000 36,100 1,622 36,100 36,200 1,627 36,200 36,300 1,631 36,300 36,400 1,636 36,400 36,500 1,640 36,500 36,600 1,645 36,600 36,700 1,649 36,700 36,800 1,654 36,800 36,900 1,658 36,900 37,000 1,663 37,000 37,100 1,667 TAXABLE INCOME TAX Over But not over 37,100 37,200 1,672 37,200 37,300 1,676 37,300 37,400 1,681 37,400 37,500 1,685 37,500 37,600 1,690 37,600 37,700 1,694 37,700 37,800 1,699 37,800 37,900 1,703 37,900 38,000 1,708 38,000 38,100 1,712 38,100 38,200 1,717 38,200 38,300 1,721 38,300 38,400 1,726 38,400 38,500 1,730 38,500 38,600 1,735 38,600 38,700 1,739 38,700 38,800 1,744 38,800 38,900 1,748 38,900 39,000 1,753 39,000 39,100 1,757 39,100 39,200 1,762 39,200 39,300 1,766 39,300 39,400 1,771 39,400 39,500 1,775 39,500 39,600 1,780 39,600 39,700 1,784 39,700 39,800 1,789 39,800 39,900 1,793 39,900 40,000 1,798 40,000 40,100 1,802 40,100 40,200 1,807 40,200 40,300 1,811 40,300 40,400 1,816 40,400 40,500 1,820 40,500 40,600 1,825 40,600 40,700 1,829 40,700 40,800 1,834 40,800 40,900 1,838 40,900 41,000 1,843 41,000 41,100 1,847 41,100 41,200 1,852 41,200 41,300 1,856 41,300 41,400 1,861 41,400 41,500 1,865 41,500 41,600 1,870 41,600 41,700 1,874 41,700 41,800 1,879 41,800 41,900 1,883 41,900 42,000 1,888 42,000 42,100 1,892 42,100 42,200 1,897 42,200 42,300 1,901 42,300 42,400 1,906 42,400 42,500 1,910 42,500 42,600 1,915 TAXABLE INCOME TAX Over But not over 42,600 42,700 1,919 42,700 42,800 1,924 42,800 42,900 1,928 42,900 43,000 1,933 43,000 43,100 1,937 43,100 43,200 1,942 43,200 43,300 1,946 43,300 43,400 1,951 43,400 43,500 1,955 43,500 43,600 1,960 43,600 43,700 1,964 43,700 43,800 1,969 43,800 43,900 1,973 43,900 44,000 1,978 44,000 44,100 1,982 44,100 44,200 1,987 44,200 44,300 1,991 44,300 44,400 1,996 44,400 44,500 2,000 44,500 44,600 2,005 44,600 44,700 2,009 44,700 44,800 2,014 44,800 44,900 2,018 44,900 45,000 2,023 45,000 45,100 2,027 45,100 45,200 2,032 45,200 45,300 2,036 45,300 45,400 2,041 45,400 45,500 2,045 45,500 45,600 2,050 45,600 45,700 2,054 45,700 45,800 2,059 45,800 45,900 2,063 45,900 46,000 2,068 46,000 46,100 2,072 46,100 46,200 2,077 46,200 46,300 2,081 46,300 46,400 2,086 46,400 46,500 2,090 46,500 46,600 2,095 TAXABLE INCOME TAX Over But not over 46,600 46,700 2,099 46,700 46,800 2,104 46,800 46,900 2,108 46,900 47,000 2,113 47,000 47,100 2,117 47,100 47,200 2,122 47,200 47,300 2,126 47,300 47,400 2,131 47,400 47,500 2,135 47,500 47,600 2,140 47,600 47,700 2,144 47,700 47,800 2,149 47,800 47,900 2,153 47,900 48,000 2,158 48,000 48,100 2,162 48,100 48,200 2,167 48,200 48,300 2,171 48,300 48,400 2,176 48,400 48,500 2,180 48,500 48,600 2,185 48,600 48,700 2,189 48,700 48,800 2,194 48,800 48,900 2,198 48,900 49,000 2,203 49,000 49,100 2,207 49,100 49,200 2,212 49,200 49,300 2,216 49,300 49,400 2,221 49,400 49,500 2,225 49,500 49,600 2,230 49,600 49,700 2,234 49,700 49,800 2,239 49,800 49,900 2,243 49,900 50,000 2,248

*210104==19999* DR 0104 (12/07/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 4 2021 Colorado Individual Income Tax Return Full-Year Part-Year or Nonresident (or resident, part-year, non-resident combination) *Must include DR 0104PN Mark if Abroad on due date – see instructions Your Last Name Your First Name Middle Initial Date of Birth (MM/DD/YYYY) SSN or ITIN Deceased If checked and claiming a refund, you must include the DR 0102 and death certificate with your return. Enter the following information from your current driver license or state identification card. State of Issue Last 4 characters of ID number Date of Issuance If Joint, Spouse’s Last Name Spouse’s First Name Middle Initial Spouse’s Date of Birth (MM/DD/YYYY) Spouse’s SSN or ITIN Deceased If checked and claiming a refund, you must include the DR 0102 and death certificate with your return. Enter the following information from your spouse’s current driver license or state identification card. State of Issue Last 4 characters of ID number Date of Issuance Mailing Address Phone Number City State ZIP Code Foreign Country (if applicable) To see if you or members of your household qualify for free or reduced-cost health coverage, check this box if: • You are a Colorado resident and at least one person in your household does not have health coverage AND • You give permission for the Colorado Department of Revenue to share the information on Form DR 0104EE with Connect for Health Colorado (the Colorado Health Benefit Exchange) and the Department of Health Care Policy & Financing. Round To The Nearest Dollar 1. Enter Federal Taxable Income from your federal income tax form: 1040, 1040 SR, or 1040 SP line 15. 1 0 0 Include W-2s and 1099s with CO withholding. Additions to Federal Taxable Income 2. State Addback, enter the state income tax deduction from your federal form 1040, 1040 SR, or 1040 SP schedule A, line 5a (see instructions) 2 0 0 3. Qualified Business Income Deduction Addback (see instructions) 3 0 0 (0013)

4. Other Additions, explain (see instructions) 4 0 0 Explain: 5. Subtotal, sum of lines 1 through 4 5 0 0 Colorado Subtractions 6. Subtractions from the DR 0104AD Schedule, line 20, you must submit the DR 0104AD schedule with your return. 6 0 0 7. Colorado Taxable Income, subtract line 6 from line 5 7 0 0 Tax, Prepayments and Credits: see 104 Book for full-year tax table and part-year DR 0104PN Schedule 8. Colorado Tax from tax table or the DR 0104PN line 36, you must submit the DR 0104PN with your return if applicable. 8 0 0 9. Alternative Minimum Tax from the DR 0104AMT line 8, you must submit the DR 0104AMT with your return. 9 0 0 10. Recapture of prior year credits 10 0 0 11. Subtotal, sum of lines 8 through 10 11 0 0 12. Nonrefundable Credits from the DR 0104CR line 43, the sum of lines 12, 13, and 14 cannot exceed line 11, you must submit the DR 0104CR with your return. 12 0 0 13. Total Nonrefundable Enterprise Zone credits used – as calculated, or from the DR 1366 line 84, the sum of lines 12, 13, and 14 cannot exceed line 11, you must submit the DR 1366 with your return. 13 0 0 14. Strategic Capital Tax Credit from DR 1330, the sum of lines 12, 13, and 14 cannot exceed line 11, you must submit the DR 1330 with your return. 14 0 0 15. Net Income Tax, sum of lines 12, 13, and 14. Subtract that sum from line 11. 15 0 0 16. Use Tax reported on the DR 0104US schedule line 7, you must submit the DR 0104US with your return. 16 0 0 17. Net Colorado Tax, sum of lines 15 and 16 17 0 0 18. CO Income Tax Withheld from W-2s and 1099s, you must submit the W-2s and/or 1099s claiming Colorado withholding with your return. 18 0 0 19. Prior-year Estimated Tax Carryforward 19 0 0 20. Estimated Tax Payments, enter the sum of the quarterly payments remitted for this tax year 20 0 0 21. Extension Payment remitted with the DR 0158-I 21 0 0 22. Other Prepayments: DR 0104BEP DR 0108 DR 1079 22 0 0 23. Gross Conservation Easement Credit from the DR 1305G line 33, you must submit the DR 1305G with your return. 23 0 0 24. Innovative Motor Vehicle Credit from the DR 0617, you must submit each DR 0617 with your return. 24 0 0 Name SSN or ITIN DR 0104 (12/07/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 4 *210104==29999*

25. Refundable Credits from the DR 0104CR line 9, you must submit the DR 0104CR with your return. 25 0 0 26. Subtotal, sum of lines 18 through 25 26 0 0 Modified AGI for TABOR Lines 28 through 30 are only used to calculate your TABOR Credit, they do not affect your Colorado tax liability. 27. Federal Adjusted Gross Income from your federal income tax form: 1040 line 11, 1040 SR line 11, or 1040 SP line 11 27 0 0 28. Nontaxable Social Security Income 28 0 0 29. Nontaxable Lump-sum Distribution from pension and profit sharing plans. 29 0 0 30. Nontaxable interest income from state and local bonds 30 0 0 31. Sum of lines 27 through 30: Modified AGI for TABOR 31 0 0 Modified AGI Tiers for State Sales Tax Refund If line 31 is: $44,000 or less $44,001 – $88,000 $88,001 – $139,000 $139,001 – $193,000 $193,001 – $246,000 $246,001 – or more Single Filers Enter $37 $49 $56 $68 $74 $117 Joint Filers Enter $74 $98 $112 $136 $148 $234 32. State Sales Tax Refund: For full-year Colorado residents, born before 2003, or full-year Colorado residents who are under the age of eighteen but are required to file a return. Use the amount on line 31 and reference the table above. See instructions if you are filing an extension. 32 0 0 33. Sum of lines 26 and 32 33 0 0 34. Overpayment, if line 33 is greater than line 17 then subtract line 17 from line 33 34 0 0 35. Estimated Tax Credit Carryforward to 2022 first quarter, if any. 35 0 0 If you have an overpayment on line 36 below and would like to donate all or a portion of your overpayment to a qualified Colorado charity, include Form DR 0104CH to contribute. 36. Refund, subtract line 35 from line 34 (see instructions) 36 0 0 Direct Deposit Routing Number Type: Checking Savings CollegeInvest 529 Account Number For questions regarding CollegeInvest direct deposit or to open an account, visit CollegeInvest.org or call 800-448-2424. DR 0104 (12/07/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 3 of 4 *210104==39999* Name SSN or ITIN

*210104==49999* 37. Net Tax Due, subtract line 33 from line 17 37 0 0 38. Delinquent Payment Penalty (see instructions) 38 0 0 39. Delinquent Payment Interest (see instructions) 39 0 0 40. Estimated Tax Penalty, you must submit the DR 0204 with your return. (see instructions) 40 0 0 41. Amount You Owe, sum of lines 37 through 40 41 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. Third Party Designee Do you want to allow another person to discuss this return and any related information with the Colorado Department of Revenue? See the instructions. No Yes. Complete the following: Designee’s Name Phone Number Sign Below Under penalties of perjury, I declare that to the best of my knowledge and belief, this return is true, correct and complete. Your Signature Date (MM/DD/YY) Spouse’s Signature. If joint return, BOTH must sign. Date (MM/DD/YY) Paid Preparer’s Name Paid Preparer’s Phone Paid Preparer’s Address City State ZIP Code Name SSN or ITIN DR 0104 (12/07/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 4 of 4 If you are filing this return with a check or payment, please mail the return to: COLORADO DEPARTMENT OF REVENUE Denver, CO 80261-0006 If you are filing this return without a check or payment, please mail the return to: COLORADO DEPARTMENT OF REVENUE Denver, CO 80261-0005 These addresses and zip codes are exclusive to the Colorado Department of Revenue, so a street address is not required. File and pay at: Colorado.gov/RevenueOnline

*210104EE19999* DR 0104EE (06/03/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 2 Colorado Easy Enrollment Information Form Colorado taxpayers can now share certain information from their tax return with the Colorado Health Benefit Exchange (Connect for Health Colorado) and the Colorado Department of Health Care Policy & Financing to find out if they qualify for free or reduced-cost health coverage (Colorado Law: 39-21-113(25) C.R.S). By submitting this form (DR 0104EE) and checking the corresponding checkbox with my income tax return (form DR 0104), I give permission for the Colorado Department of Revenue to share the information included on this form with the Colorado Health Benefit Exchange (Connect for Health Colorado) and the Department of Health Care Policy & Financing Note: If you agree to share this information, please complete (or verify) this form to the best of your ability and include it with your tax return. If filing by paper, ensure that it is mailed with your return. If filing electronically through your tax preparer or a using a software program, this form may be completed using the software. If you do not agree to share this information, please do not complete this form and do not include it with your return. Section A: Household Contact Information Last Name First Name Middle Initial Phone Number Email Address Mailing Address (Line 1) Mailing Address (Line 2) City State ZIP Code

Section B: Household Member and Income Information Complete this section with information for all members of your tax household. For purposes of obtaining health coverage, your tax household typically consists of yourself, your spouse, and any person that you claim as a tax dependent on your federal income tax return. For more information about who may be claimed as a tax dependent on your federal income tax return and would be considered a part of you tax household, review IRS Publication 501. 1. Enter your tax household size here. Include yourself, your spouse, and all individuals that you claim as a dependent on your federal income tax return (i.e. a household with spouses filing jointly and one tax dependent child = household size of 3; enter “3” in this field). 1 2. Enter your adjusted gross income from line 11 on your federal form 1040, 1040-SR, 1040(SP), or 1040-NR. 2 0 0 3. Enter information about yourself, your spouse, and all individuals that you claim as a dependent on your federal income tax return in the table below. Last Name First Name Middle Initial Date of Birth SSN or ITIN (optional) *210104EE29999* DR 0104EE (06/03/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 2

*210104CH19999* DR 0104CH (11/08/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 2 2021 Voluntary Contributions Schedule If you are making a voluntary contribution and filing by paper, you must submit this schedule with your return. Instructions: Name SSN or ITIN If line 36 on the DR 0104 is NOT greater than zero, STOP. You cannot complete this schedule. 1. Colorado Nongame Conservation and Wildlife Restoration Cash Fund 1 0 0 2. Colorado Domestic Abuse Program Fund 2 0 0 3. Homeless Prevention Activities Program Fund 3 0 0 4. Western Slope Military Veterans Cemetery Fund 4 0 0 5. Pet Overpopulation Fund 5 0 0 6. Military Family Relief Fund 6 0 0 7. American Red Cross Colorado Disaster Response, Readiness, and Preparedness Fund 7 0 0 8. Habitat for Humanity of Colorado Fund 8 0 0 9. Special Olympics of Colorado Fund 9 0 0 10. Colorado Healthy Rivers Fund 10 0 0 11. Alzheimer’s Association Fund 11 0 0 12. Colorado Cancer Fund 12 0 0 13. Make-A-Wish Foundation of Colorado Fund 13 0 0 Use this form to make voluntary contributions using your refund to selected Colorado charities. If you would like to donate all or a portion of your refund to one of the organizations available to receive voluntary contributions, enter the desired amount here. See the back of the 104 Book for more information about each of these charitable organizations. You must submit this form along with the DR 0104 to ensure that your selected organizations receive the donations you have designated.

Name SSN or ITIN DR 0104CH (11/08/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 2 *210104CH29999* 14. Unwanted Horse Fund 14 0 0 15. Urban Peak Housing and Support Services for Youth Experiencing Homelessness Fund 15 0 0 16. This line is reserved for future use. 16 17. Donate to a Colorado Nonprofit Fund 17 0 0 Enter the 11-digit Secretary of State Registration Number for the Registered Charitable Organization Enter the Name of the Registered Charitable Organization 18. Total of lines 1 through 17. This cannot exceed the amount on line 36 on the DR 0104. 18 0 0 19. Subtract line 18 from the amount on line 36 on the DR 0104. This is the amount of your net refund. (See box below) 19 0 0 DO NOT CUT – Return Full Page This form is used to request a donation to a qualified charity or charities from your tax refund. The amount of your donation(s) requested on this form may be decreased if a reduction is made to your refund after processing of your return. Donation(s) will also be decreased if you owe back taxes or if you owe a balance to another Colorado government agency or the IRS. Amounts cannot be changed once your return has been submitted. Donation requests cannot be changed with an amended return.

*210104AD19999* DR 0104AD (10/22/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 2 2021 DR 0104AD – Subtractions from Income Schedule If claiming a subtraction and filing by paper, you must submit this schedule with your return. Use this schedule to report any subtractions from your Federal Taxable Income. These subtractions will change your Colorado Taxable Income from the amount of Federal Taxable Income. See instructions in the income tax booklet for additional guidance on completing this schedule. Do not enter negative amounts. You must submit this form along with the DR 0104 if claiming any subtractions. Name SSN or ITIN Subtractions from Federal Taxable Income 1. State Income Tax Refund from federal income tax form 1040, 1040 SR, or 1040 SP, Schedule 1 line 1. 1 0 0 2. U.S. Government Interest 2 0 0 3. Primary Taxpayer Pension, Annuity, IRA, Social Security, or Disability Income (see instructions) Deceased SSN or ITIN 3 0 0 4. Spouse Pension, Annuity, IRA, Social Security, or Disability Income (see instructions) Deceased SSN or ITIN 4 0 0 5. Primary Taxpayer Military Retirement Benefits (under age 55), you must submit copies of all 1099R statements with your return. (see instructions) 5 0 0 6. Spouse Military Retirement Benefits (under age 55), you must submit copies of all 1099R statements with your return. (see instructions) 6 0 0 7. Colorado Capital Gain Subtraction 7 0 0 8. CollegeInvest Contribution: (see instructions) Owner’s SSN or ITIN 8 0 0 Total Contribution Owner’s Name 9. Qualifying Charitable Contribution Total Contribution 9 $ 0 0 10. Qualified Reservation Income 10 0 0 11. PERA/DPSRS Subtraction, for PERA contributions made in 1984–1986 or DPSRS contributions made in 1986 11 0 0

*210104AD29999* DR 0104AD (10/22/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 2 Name SSN or ITIN 12. Railroad Benefit Subtraction 12 0 0 13. Wildfire Mitigation Measures Subtraction 13 0 0 14. Colorado Marijuana Business Deduction

14 0 0 15. Non-Resident Disaster Relief Worker Subtraction

15 0 0 Natural Disaster: Enter the executive order number(s) from the Colorado governor’s office that declared the state disaster emergency “D YYYY-###” (see instructions) 16. Reacquisition of Colorado Residency During Active Duty Military Service Subtraction 16 0 0 17. First Time Home Buyer Savings Account Interest Deduction, you must submit form DR 0350(s) with your return 17 0 0 18. Other Subtractions, explain below 18 0 0 Explain 19. Subtractions Allowed Under HB21-1002 (see instructions) 19 0 0 20. Subtotal, sum of lines 1 through 19, transfer the amount to line 6 on the DR 0104 20 0 0

*210900==19999* DR 0900 (06/03/21) COLORADO DEPARTMENT OF REVENUE Denver CO 80261-0008 Tax.Colorado.gov Page 1 of 1 (0011) 2021 Individual Income Tax Payment Form (Calendar year — Due April 15, 2022) Caution! This form MUST accompany your payment if you filed electronically and wish to pay by check. If you paid electronically or do not owe a payment do not file this form. DR 0900 (06/03/21) Return the DR 0900 with check or money order payable to the “Colorado Department of Revenue”. Mail payments to Colorado Department of Revenue, Denver, Colorado 80261-0008. These addresses and zip codes are exclusive to the Colorado Department of Revenue, so a street address is not required. Write your Social Security number or ITIN and “2021 DR 0104” on your check or money order. Do not send cash. Enclose, but do not staple or attach, your payment with this form. SSN or ITIN Your Last Name First Name Middle Initial Spouse’s SSN or ITIN Spouse’s Last Name (if joint) Spouse’s First Name Middle Initial Address City State ZIP Code

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. Amount of Payment $ DO NOT CUT – Return Full Page DO NOT CUT – Return Full Page The Department strongly recommends that you file using Revenue Online (Colorado.gov/RevenueOnline) or another electronic filing method and remit your payment electronically or by EFT. Information on EFT can be found at Tax.Colorado.gov/electronic-funds-transfer To pay by mail, make the check or money order payable to the “Colorado Department of Revenue.” Be sure to round your payment to the nearest dollar. Clearly write your Social Security number or ITIN and “2021 DR 0104” on the memo line. Be sure to keep a copy of the money order or note the check number with your tax records. Complete the form below. The amount on the check and the amount entered on the payment form must be the same. This will help maintain accuracy in your tax account. DO NOT submit the DR 0104 if you have already filed electronically. IF NO PAYMENT IS DUE, DO NOT FILE THIS FORM

*210158-I19999* DR 0158-I (06/03/21) COLORADO DEPARTMENT OF REVENUE Denver CO 80261-0008 Tax.Colorado.gov Page 1 of 1 (0019) 2021 Extension Payment for Colorado Individual Income Tax (calendar year — Due April 15, 2022) Filing extensions are granted automatically, only return this form if you need to make an additional payment of tax. DR 0158-I (06/03/21) Tax Payment Worksheet – Photocopy for your records before returning 1. Income tax you expect to owe 2. Tax payments and credits: a. Colorado income tax withheld b. Colorado estimated income tax payments c. Other payments and credits d. Total tax payments and credits – Add lines 2a through 2c 3. Tax due–Subtract line 2d from line 1. Enter the result here and on the form below Return the DR 0158-I with check or money order payable to the “Colorado Department of Revenue”. Mail payments to Colorado Department of Revenue, Denver, Colorado 80261-0008. These addresses and zip codes are exclusive to the Colorado Department of Revenue, so a street address is not required. Write your Social Security number or ITIN and “2021 DR 0158-I” on your check or money order. Do not send cash. Enclose, but do not staple or attach, your payment with this form. File only if you are making a payment by check or money order. SSN or ITIN Your Last Name First Name Middle Initial Spouse’s SSN or ITIN Spouse’s Last Name (if joint) Spouse’s First Name Middle Initial Address City State ZIP Code 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. Amount of Payment $ DO NOT CUT – Return Full Page IF NO PAYMENT IS DUE, DO NOT FILE THIS FORM Automatic Filing Extension Colorado offers an automatic six-month extension to file your income tax return if you cannot submit your return by the April 15 due date. This means that you can file your return by October 15. While there is an extension to file, there is not an extension to the payment due date. Penalty and interest are assessed if certain payment criteria are not met. Please review FYI General 11 for more information on penalty and interest. If you must wait until October 15 to file your return, use the following worksheet to calculate whether you need to remit a payment on April 15. If the due date falls on a weekend or federal holiday, payment will be due the next business day. Persons Traveling or Residing Abroad If you are traveling or residing outside the United States on April 15, the deadline for filing your return is June 15. The extension due date for filing remains October 15. If the due date falls on a weekend or federal holiday, payment will be due the next business day. Pay Online Visit Colorado.gov/RevenueOnline to pay online. Online payments reduce errors and provide instant payment confirmation. Revenue Online also allows users to submit various forms and to monitor their tax account. Electronic Funds Transfer (EFT) Debit and Credit options are free services offered by the department. EFT services require pre-registration before payments can be made. Visit Tax.Colorado.gov/electronic-funds-transfer for more information. The DR 0158-I is not required to be sent if an online payment is made. Please be advised that a nominal processing fee may apply to e-check or credit card payments.

*210104PN19999* Form 104PN Part-Year Resident/Nonresident Tax Calculation Schedule 2021 Taxpayer’s Name SSN or ITIN Use this form if you and/or your spouse were a resident of another state for all or part of 2021. This form apportions your gross income so that Colorado tax is calculated for only your Colorado income. Complete this form after you have filled out lines 1 through 7 of the DR 0104. If you filed federal form 1040NR, see the instructions. Beginning (MM/YY) Ending (MM/YY) 1. Taxpayer is (mark one): Full-Year Nonresident Part-Year Resident from Full-Year Resident Nonresident 305-day rule Military Beginning (MM/YY) Ending (MM/YY) 2. Spouse is (mark one): Full-Year Nonresident Part-Year Resident from Full-Year Resident Nonresident 305-day rule Military 3. Mark the federal form you filed: 1040 1040 NR 1040 SR Other Federal Information Colorado Information 4. Enter all income from form 1040, 1040 SR, or 1040 SP line 1. 4 00 5. 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. 5 00 6. Enter the sum of all interest/dividend income from form 1040, 1040 SR or 1040 SP lines 2b and 3b. 6 00 7. Enter income from line 6 that was earned while you were a resident of Colorado or derived from the ownership of real or tangible personal property located in Colorado. 7 00 8. Enter all income from form 1040, 1040 SR or 1040 SP, Schedule 1, line 7. 8 00 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 Colorado resident. 9 00 10. Enter all income from line 7 of form 1040, 1040 SR, or 1040 SP and line 4 of Schedule 1 of form 1040, 1040 SR or 1040 SP. 10 00 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 00 DR 0104PN (11/15/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 3

Federal Information Colorado Information 12. Enter the sum of all income from form 1040, 1040 SR, or 1040 SP lines 4b, 5b and 6b. 12 00 13. Enter income from line 12 that was received during that part of the year you were a Colorado resident. 13 00 14. Enter the sum of all business and farm income from form 1040, 1040 SR, or 1040 SP, Schedule 1, lines 3 and 6. 14 00 15. Enter income from line 14 that was earned during that part of the year you were a Colorado resident and/or was earned from Colorado sources. 15 00 16. Enter all Schedule E income from form 1040, 1040 SR, or 1040 SP, Schedule 1, line 5. 16 00 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 the part of the year you were a Colorado resident; and/or partnership/S corporation/fiduciary income that is taxable to Colorado during the tax year. 17 00 18. Enter the sum of all other income from form 1040, 1040 SR, or 1040 SP, Schedule 1, lines 1, 2a and 9. 18 00 List Type 19. Enter income from line 18 that was earned during that part of the year you were a Colorado resident and/or was derived from Colorado sources. 19 00 List Type 20. Total Income. Enter amount from form 1040, 1040 SR, or 1040 SP, line 9. 20 00 21. Total Colorado Income. Enter the total from the Colorado column, lines 5, 7, 9, 11, 13, 15, 17 and 19. 21 00 22. Enter all federal adjustments from form 1040, 1040 SR, or 1040 SP, line 10. 22 00 List Type 23. Enter adjustments from line 22 as follows 23 00 List Type • Educator expenses, IRA deduction, business expenses of reservists, performing artists and fee-basis government officials, health savings account deduction, self-employment tax, self-employed health insurance deduction, SEP and SIMPLE deductions are allowed in the ratio of Colorado wages and/or self-employment income to total wages and/or self-employment income. • Student loan interest deduction, alimony, and tuition and fees deduction are allowed in the Colorado to federal total income ratio (line 21 / line 20). • Penalty paid on early withdrawals made while a Colorado resident. • Moving expenses for members of the Armed Forces. For treatment of other adjustments reported on federal form 1040, 1040 SR, or 1040 SP, line 10, see the Colorado Individual Income Tax Guide and/or the Income Tax Topics: Part-Year Residents & Nonresidents. DR 0104PN (11/15/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 3 *210104PN29999* Name SSN or ITIN

DR 0104PN (11/15/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 3 of 3 *210104PN39999* Federal Information Colorado Information 24. Adjusted Gross Income. Enter amount from form 1040, 1040 SP, or 1040 SR line 11. 24 00 25. Colorado Adjusted Gross Income. Subtract the amount on line 23 of Form 104PN from the amount on line 21 of Form 104PN. 25 00 26. Additions to Adjusted Gross Income. Enter the sum of lines 3 and 4 of Colorado Form 104 excluding any charitable contribution adjustments. 26 00 27. Additions to Colorado Adjusted Gross Income. Enter any amount from line 26 that is from non-Colorado state or local bond interest earned while a Colorado resident.* 27 00 28. Total of lines 24 and 26 28 00 29. Total of lines 25 and 27 29 00 30. Subtractions from Adjusted Gross Income. Enter the amount from line 6 of Colorado Form 104 excluding any qualifying charitable contributions. 30 00 31. Subtractions from Colorado Adjusted Gross Income. Enter any amount from line 30 as follows: 31 00 • The state income tax refund subtraction to the extent included on line 19 above • The federal interest subtraction to the extent included on line 7 above • The pension/annuity subtraction and the PERA or DPS retirement subtraction to the extent included on line 13 above • The Colorado capital gain subtraction to the extent included on line 20 above For treatment of other subtractions, see the Individual Income Tax Guide and/or the Income Tax Topics: Part-Year Residents & Nonresidents. 32. Modified Adjusted Gross Income. Subtract line 30 from line 28. 32 00 33. Modified Colorado Adjusted Gross Income. Subtract line 31 from line 29. 33 00 34. Divide line 33 by line 32. Round to four significant digits, e.g. xxx.xxxx 34 % 35. Tax from the tax table based on income reported on the DR 0104 line 7 35 00 36. Apportioned tax. Multiply line 35 by the percentage on line 34. Enter here and on DR 0104 line 8. 36 00 Name SSN or ITIN * See the Individual Income Tax Guide and/or the Income Tax Topics: Part-Year Residents & Nonresidents for treatment of other additions.

*210104US19999* DR 0104US (09/30/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 1 2021 Consumer Use Tax Reporting Schedule Use this schedule to report consumer use tax due. This is one of three methods of filing to pay a consumer use liability. You may also use Revenue Online or file a DR 0252, Consumer Use Tax Return. See instructions or more information on how to file. What is Consumer Use Tax? Individuals and businesses are required to pay use tax on tangible personal property purchased from vendors either inside or outside of this state if the property is used, stored, or consumed within the state and sales tax was not collected or paid on the property. For more information on your consumer use tax obligation, including how to use the annual customer reports from non-collecting retailers, please visit Tax.Colorado.gov/Consumer-Use-Tax Special Districts also assess a use tax. More than half of Colorado residents live in one or more of these districts. The special districts that assess use tax and the applicable tax rates can be found at https://Colorado.TTR.Services. DO NOT CUT – If filing by paper, return full page WITH the 2021 DR 0104 form Name SSN or ITIN 1. Enter the total purchases for which state sales or use tax was not previously paid. 1 0 0 2. Multiply line 1 by 0.029. Enter the result in whole dollars here. 2 0 0 3. Enter the total purchases for which special district sales or use tax was not previously paid. 3 0 0 4. Enter the 2-digit SDCU Code for any applicable special district(s). See instructions. 4 5. Enter the corresponding use tax rate. See instructions. 5 6. Multiply line 3 by the rate on line 5. Enter the result in whole dollars here. 6 0 0 7. Add line 2 and line 6, transfer to the DR 0104 line 16. 7 0 0 DO NOT CUT – If filing by paper, return full page WITH the 2021 DR 0104 form

*210104CR19999* Form 104CR Individual Credit Schedule 2021 Taxpayer’s Last Name First Name Middle Initial SSN or ITIN Use this schedule to calculate your income tax credits. For best results, visit Tax.Colorado.gov to research eligibility requirements and other information about these credits before following the line-by-line instructions contained below. • Be sure to submit the required supporting documentation as indicated for each credit. • Most e-file software and tax preparers have the ability to submit this schedule and attachments electronically. However, Revenue Online can also be used to file your return and attachments electronically. Otherwise, include all required documents with your paper return. • If you received any of these credits from a pass-through entity, be sure to provide the entity’s name and account number and your ownership percentage where required. If credits were passed through from multiple entities, submit with your return a written statement that includes all relevant information. • Dollar amounts shall be rounded to the nearest whole dollar. Calculate percentages to the fourth decimal place. Round to four significant digits, e.g. xxx.xxxx Part I — Refundable Credits 1. Child Care Expenses Credit from the DR 0347, you must submit the DR 0347 with your return. 1 00 SSN Filers Only - Earned Income Tax Credit (EITC) - full or part-year Colorado residents who claim the federal EITC are allowed an earned income tax credit against their income tax. Complete the table for each qualifying child. Read the instructions in the 104 book and Income Tax Topics: Earned Income Tax Credit for additional guidance on completing this section. Only check the “Deceased” box for a qualifying child if the child was born and died in 2021 and was not assigned an SSN. You must submit a copy of the child’s birth certificate, death certificate, or hospital records showing a live birth with your return. 2. Enter the amount of Earned Income calculated for your federal return. 2 00 3. The federal EITC you claimed. 3 00 Qualifying Child’s Last Name Qualifying Child’s First Name Year of Birth SSN Deceased* *Check only if child was deceased before SSN was assigned in 2021, see instructions. DR 0104CR (09/30/21)

COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 4

4. COEITC, multiply line 3 by 10% (0.10) 4 00 5. Part-year residents only, multiply line 4 by the percentage on line 34 of the DR 0104PN (If the percentage exceeds 100%, use 100%.) 5 00 6. Business Personal Property Credit: Use the worksheet in the 104 Book instructions to calculate. You must submit copy of the assessor’s statement with your return. 6 00 7. Refundable Renewable Energy Tax Credit from line 85 of the DR 1366. You must submit the DR 1366 with your return. 7 00 8. ITIN Filers Only - Expanded Colorado Earned Income Tax Credit from line 20 (or 21) of form DR 0104TN. You must submit the DR 0104TN with your return. 8 00 9. Total Refundable Credits, sum of lines 1, 4 (or 5), 6, 7, and 8. Enter the sum on the DR 0104 line 25.

9 00 Part II — Credit for Tax Paid to Another State • Colorado nonresidents do not qualify for this credit. • Part-year residents generally do not qualify for this credit. • If you have income and/or losses from two or more states, you must separately calculate lines 11 through 17 for each state, regardless of whether any tax was paid on such income. If you do not file electronically, you must submit the DR 0104CR for each state. Then, enter “Combined” on line 10 and complete lines 11 through 17 to disclose the combined total for each line. A summary schedule is not acceptable. The Department strongly recommends electronic filing for taxpayers with credits for more than one state. Failure to file electronically may result in delays processing your return. Submit a copy of the tax return for each other state when claiming this credit. The portion of the return submitted must include the adjusted gross income calculation, any disallowed federal deductions by that state, and the tax calculation for the other state. 10. Name of other state: 11. Total of lines 8 and 9 Form 104 11 00 12. Modified Colorado adjusted gross income from sources in the other state, see FYI Income 17. 12 00 13. Total modified Colorado adjusted gross income 13 00 14. Divide line 12 by line 13. Round to four significant digits, e.g. xxx.xxxx 14 % 15. Multiply line 11 by the percentage on line 14 15 00 16. Tax liability to the other state 16 00 17. Allowable credit, the smaller of lines 15 or 16 17 00 DR 0104CR (09/30/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 4 *210104CR29999* Name SSN or ITIN

Part III — Other Credits Visit Tax.Colorado.gov for limitations that are specific to each credit. To report this properly, use the first column to report the total credit that is available (the amount generated this year plus any prior-year carryforward). Then, use the second column to report the amount you are using this year to offset your tax liability. Available Credit Column (A) Credit Used Column (B) 18. Plastic recycling investment credit, you must submit required receipts with your return. 18 00 00 Plastic recycling net expenditures amount (fill below): 19. Colorado Minimum Tax Credit 19 00 00 2021 Federal Minimum Tax Credit (fill below): 20. Carry forward of prior year Historic Property Preservation credit (per §39-22-514, C.R.S.). 20 00 00 21. Child Care Center Investment credit, you must submit a copy of your facility license and a list of depreciable tangible personal property with your return. 21 00 00 22. Employer Child Care Facility Investment credit, you must submit a copy of your facility license and a list of depreciable tangible personal property with your return. 22 00 00 23. School-to-Career Investment credit, you must submit a copy of the certification with your return. 23 00 00 24. Colorado Works Program credit, you must submit a copy of the letter from the county Department of Social/Human Services with your return. 24 00 00 25. Child Care Contribution credit, you must submit each DR 1317 with your return. 25 00 00 26. Long-term Care Insurance credit, you must submit a year-end statement to show premiums paid with your return. See FYI Income 37. 26 00 00 27. Aircraft Manufacturer New Employee credit, you must submit the DR 0085 and DR 0086 with your return. 27 00 00 28. Credit for Environmental Remediation of Contaminated Land, you must submit a copy of the CDPHE certification with your return. 28 00 00 29. Colorado Job Growth Incentive credit, you must submit certification from OEDIT with your return. 29 00 00 30. Certified Auction Group License Fee credit, you must submit a copy of the certification with your return. 30 00 00 31. Advanced Industry Investment credit, you must submit a copy of the certification with your return. 31 00 00 32. Affordable Housing credit, you must submit CHFA certification with your return. 32 00 00 DR 0104CR (09/30/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 3 of 4 *210104CR39999* Name SSN or ITIN

DR 0104CR (09/30/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 4 of 4 *210104CR49999* Available Credit Column (A) Credit Used Column (B) 33. Carry forward of prior year Credit for Food Contributed to Hunger-Relief Charitable Organizations, you must submit each DR 0346 and federal schedule F with your return. 33 00 00 34. Preservation of Historic Structures credit (per §39- 22-514.5, C.R.S.) carried forward from a prior year. 34 00 00 35. Preservation of Historic Structures credit (per §39-22- 514.5, C.R.S.), you must submit the certificate from OEDIT, History Colorado, or local granting authority with your return. 35 00 00 36. If you are claiming the Preservation of Historic Structures credit enter your credit certificate number issued by OEDIT, History Colorado, or local granting authority. 36 37. Rural Jump–Start Zone credit, you must submit certificate from Office of Economic Development AND the DR 0113 with your return. 37 00 00 38. Rural & Frontier Health Care Preceptor credit, you must submit your certification with your return. 38 00 00 39. Retrofitting a Residence to Increase a Residence’s Visitability Credit, you must submit certificate from Division of Housing. 39 00 00 If you are claiming a Retrofitting a Residence to Increase a Residence’s Visitability Credit, enter your credit certificate number issued by Division of Housing 40. Credit for employer contributions to employee 529 plan, you must submit DR 0289 with your return. 40 00 00 41. Credit for employer paid leave of absence for live organ donation. Employer must complete and submit form DR 0375 with their return. 41 00 00 42. Total of column A lines 18 through 41 (exclude line 36 certificate number) 42 00 43. Nonrefundable Credits Used, total of column B plus any amount from line 17, exclude line 36 certificate number. Also enter this amount on the DR 0104 line 12. Credit used cannot exceed credit available.

43 00 Name SSN or ITIN

Earned Income Tax Credit and the Child Tax Credit refunds may be available to you. Even if you earn little to no money, by filing your taxes you could receive these valuable tax refunds that can help you pay for groceries, rent, car repairs, clothes, or even to start a savings fund. CHILD TAX CREDIT (CTC) Grandparents raising grandchildren or parents with disabilities can receive up to $3,000 for every child ages 6 to 17 and $3,600 for every child under the age of 6. People who aren’t working or haven’t filed taxes recently or ever before can still get cash back. Colorado residents with social security numbers or individual taxpayer identification numbers (ITIN) can claim CTC refunds. Each child claimed must have a social security number. EARNED INCOME TAX CREDIT (EITC) Individual workers who are at least 25 but under 65 years of age can receive up to $1,500 in EITC payments. Workers raising children can receive up to $6,700 in EITC refunds. Individuals and families who earn up to $57,000 a year in income usually qualify for some amount of EITC credit. FILING YOUR TAXES IS EASIER THAN YOU THINK! VISIT GETAHEADCOLORADO.ORG TO GET STARTED FOR FREE.

Use this form to determine if you can claim the Colorado Child Care Expenses tax credit. You may be able to claim the credit if you pay someone to care for your dependent who is under age 13. For information about any federal form or publication listed below, please visit IRS.gov Eligibility To be able to claim the Colorado credit for child care expenses, you must file federal form 1040, 1040SR, 1040SP, or 1040NR and you (and/or your spouse) must have been a part or full-year resident of Colorado. Colorado non-resident filers may not claim this credit. If you did not file a federal income tax return, you may still be eligible for the Low Income Child Care Expenses credit. To claim the low income credit, you must complete and submit with your Colorado return, federal return and form 2441. You must also meet all of the following tests: 1. The care must be for one or more qualifying persons who are identified on federal form 2441. 2. You (and your spouse if filing jointly) must have earned income during the year. 3. You must pay child care expenses so you (and your spouse if filing jointly) can work or look for work. Qualifying expenses are defined under Section 21 of the Internal Revenue Code. 4. You must make payments for child care expenses to someone you (and your spouse) cannot claim as a dependent. If you make payments to your child, he or she cannot be your dependent and must be age 19 or older by the end of the year. You cannot make payments to: a. Your spouse, or b. The parent of your qualifying person if your qualifying person is your child and under the age of 13. 5. You cannot claim this credit if your federal filing status is Married Filing Separate. 6. You must identify the care provider on this form. It is recommended that you fully review IRS Publication 503 for eligibility tests and the definition of qualifying income and children. All of the information in this form is required and your credit may be denied if it is incomplete. Part I – Person or Organization Who Provided the Care Use this section to list the name, address and Social Security or Federal Employer ID number of the child care provider(s) you used. If you are unable to provide the Social Security or Federal Employer ID number of the child care provider, you must show that you attempted to obtain the required information by including such proof with this form. List the total amount paid for the full year of child care, paid to each provider. If you have more than two care providers or if the provider is non-profit, we strongly suggest you file your return electronically. Part II – Qualifying Child Information For lines 2a – 2d, list each qualifying child, their year of birth and their Social Security number. You must also list the amount of child care expenses for each specific child. Complete lines 2e through 4 as instructed on the form. If the amount on line 4 is greater than $60,000 do not continue because you do not qualify for this credit. If line 4 is $60,000 or less, enter the amount from line 9a of the IRS form 2441, Child and Dependent Care Expenses, on line 5 of this form DR 0347. For line 6 enter your tax from your federal income tax return. See IRS form 1040, 1040SR, 1040SP, or 1040NR line 18. If you claimed a Federal Child Care Tax Credit, continue to Part III. Otherwise, if you could not not claim a Federal Child Care Tax Credit and your adjusted gross income is $25,000 or less, skip to Part IV. If you have more than four qualifying children, we strongly suggest you file your return electronically. Part III – Child Care Expenses Credit For line 8 enter the amount from line 10 of IRS form 2441 or, if you were required to complete line 11 of IRS form 2441, the amount from line 11 of IRS form 2441. For line 9 multiply line 8 by the decimal on line 7. Full–year residents should enter amount from this form on line 9 to form DR 0104CR line 1. If you completed Part III and you were a part-year resident, continue to Part V. Part IV – Low-Income Child Care Expenses If you were unable to claim the Federal Child Care Tax Credit and the amount of line 4 is $25,000 or less, use Table A to calculate the credit. Otherwise, go back to Part III to calculate your credit. For line 11 multiply line 3 by the decimal on line 10. For line 12 enter the smaller amount of line 11 or the appropriate amount from Table A. Full–year residents should enter amount from this form on line 12 to form DR 0104CR line 1. If you completed Part III and you were a part-year resident, continue to Part V. Part V – Part Year Resident Limitation Complete this part only if you were a part-year resident of Colorado in 2021. Enter the percentage from the DR 0104PN line 34 on line 13 of this DR 0347. For line 14 multiple the amount from line 9 or line 12 by the percentage from line 13. Enter this amount on line 1 of the DR 0104CR. Child Care Expenses Tax Credit Instructions DR 0347 (01/18/22) COLORADO DEPARTMENT OF REVENUE Denver CO 80261-0005 Tax.Colorado.gov *DO=NOT=SEND*

DR 0347 (01/18/22) COLORADO DEPARTMENT OF REVENUE Denver CO 80261-0005 Tax.Colorado.gov Page 1 of 2 For Tax Year You MUST submit this form with your complete Colorado Individual Income Tax Return, including forms DR 0104 and DR 0104CR. You must also submit a copy of your federal income tax return and IRS form 2441 with your Colorado return. Thoroughly read the instructions to be certain you are eligible for this credit. Be sure to complete all required information. Failure to do so may result in a denied credit or delayed refund. Taxpayer Name SSN or ITIN Part I – Persons or Organizations Who Provided the Care – You must complete this part If you have more than two care providers or if the provider is non-profit, see the instructions. 1(a). Care Provider’s First Name or Business Name Last Name Middle Initial (b) SSN, ITIN or FEIN (c) Address City State ZIP (d) Amount Paid $ (e) Care Provider’s First Name or Business Name Last Name Middle Initial (f) SSN, ITIN or FEIN (g) Address City State ZIP (h) Amount Paid $ Part II – Qualifying Child Information – You must complete this part If you have more than four qualifying children, see the instructions. 2(a). Child’s First Name Last Name Middle Initial Year of Birth SSN or ITIN Qualified expenses you incurred and paid in 2021 for the person listed in 2(a) $ 2(b). Child’s First Name Last Name Middle Initial Year of Birth SSN or ITIN Qualified expenses you incurred and paid in 2021 for the person listed in 2(b) $ *210347==19999* 2021 Child Care Expenses Tax Credit

*210347==29999* DR 0347 (01/18/22) COLORADO DEPARTMENT OF REVENUE Denver CO 80261-0005 Page 2 of 2 Taxpayer Name Account Number 2(c). Child’s First Name Last Name Middle Initial Year of Birth SSN or ITIN Qualified expenses you incurred and paid in 2021 for the person listed in 2(c) $ 2(d). Child’s First Name Last Name Middle Initial Year of Birth SSN or ITIN Qualified expenses you incurred and paid in 2021 for the person listed in 2(d) $ 2(e). Enter the sum of all qualified child care expenses $ 2(f).Enter your earned income $ 2(g). If filing a joint return, enter the earned income of the other person $ 3. Enter the smallest of line 2(e), 2(f) [or 2(g) only if filing a joint return] 3 $ 4. Enter your adjusted gross income from your federal income tax return. See IRS form 1040, 1040-SR, 1040-SP, or 1040-NR line 11 4 $ If the amount of line 4 is greater than $60,000 STOP – you do not qualify for this credit. 5. Enter the amount from line 9a of IRS form 2441, child and dependent care expenses 5 $ 6. Enter your tax from your federal income tax return. See IRS form 1040, 1040-SR, 1040-SP, or 1040-NR line 18 6 $ Complete Part III if you claimed a Federal Child Care Tax Credit Part III – Child Care Expenses Credit 7. DO NOT complete this form if Line 4 is greater than $60,000. 7 0.50 8. Enter the amount from line 10 of IRS Form 2441 or, if you were required to complete line 11 of IRS Form 2441, the amount from line 11 of IRS Form 2441 8 9. Multiply line 8 by the decimal on line 7 9 Part IV – Low-Income Child Care Expenses Credit 10. Low-income calculation only. DO NOT complete this Part IV if line 4 is greater than $25,000 10 0 .25 11. Multiply line 3 by the decimal on line 10 11 Table A One qualifying child .............................. $500 Two or more qualifying children ...........$1,000 12. Enter the smaller of line 11 or the appropriate amount from Table A 12 Full-year residents should enter the appropriate amount from line 12 on Form 104CR line 1. Part-year residents skip to Part V Part V – Part-Year Resident Limitation 13. Part-year residents ONLY – enter the percentage from the DR 0104PN line 34. If percentage exceeds 100% from the DR 0104PN, line 34, enter 100% 13 % 14. Multiply the amount from line 9 or line 12 by the percentage from line 13. Enter the result on line 1 of the DR 0104CR 14 $

Page 47 Voluntary Contribution Eligible Funds A simple way to give. Complete form DR 0104CH Voluntary Contributions Schedule to contribute to any of these charitable funds. Colorado Nongame Conservation and Wildlife Restoration Cash Fund Nongame wildlife includes 750 species of wildlife that cannot be hunted, fished for or trapped. Funds go to projects that manage or recover wildlife such as lynx, river otter, black-footed ferret, green back cutthroat, and others. The nongame program receives no state tax dollars and depends on voluntary contributions. Domestic Abuse Program Fund Donations to this fund help support critical services provided by community-based domestic abuse programs across Colorado. These agencies provide 24-hour crisis line response, emergency safe shelter, counseling and advocacy services for victims of domestic violence and their children and information and referrals for their communities, and community education. Homeless Preventive Activities Program Fund Approximately 52,000 people in Colorado are at risk of becoming homeless this year. Keeping people in their homes saves tax dollars and is an effective and humane way of helping families in crisis. Your contribution will be used to support activities and programs which help prevent people from becoming homeless. Western Slope Military Veterans Cemetery Fund Funds assist in the maintenance of the Veterans Memorial cemetery of Western Colorado. The veterans cemetery is intended as a dignified final resting place for Colorado’s veterans and eligible dependents. It is a place of quiet contemplation for the veterans community. Please help maintain this solemn beauty for Colorado veterans. Pet Overpopulation Fund The Pet Overpopulation Fund provides funding to local animal care and control organizations and veterinarians for sterilization surgeries for pets owned by Coloradans in areas of the state with the greatest need. The Fund also supports efforts to educate the public about the importance of preventing pet overpopulation. Military Family Relief Fund Provides emergency grants for financial hardships to members of Colorado National Guard or Reservist and their families when ordered to Active Military duty and to Active Duty Military Personnel stationed in Colorado and their family members when the Active Duty military member is deployed to a declared hostile fire zone. American Red Cross Colorado Disaster Response, Readiness, and Preparedness Fund The American Red Cross prevents and alleviates human suffering in the face of emergencies. In Colorado, the Red Cross teaches tens of thousands of people lifesaving skills every year, provides critical services for members of the military and their families and responds to, on average, a disaster a day. Habitat for Humanity of Colorado Fund Seeking to put God’s love into action, Habitat for Humanity brings people together to build homes, communities and hope. Through volunteer labor and donations, Habitat for Humanity builds and rehabilitates simple, decent homes in partnership with hardworking low-income individuals and families in 45 Colorado communities. Special Olympics of Colorado Fund Special Olympics Colorado provides year-round athletic competition in 22 sports for over 19,000+ athletes with intellectual disabilities from 2 to 80+ years old. We create inclusive and welcoming schools for children with all differences through unified sports and youth leadership. Programs are free of charge to athletes and their families. Colorado Healthy Rivers Fund This fund protects Colorado’s lands and waterways. The state’s streams, wetlands, mountains and forests serve many needs including water supply, agriculture, wildlife and recreation. Your generous support of this program will fund stream restoration projects and assist local groups in watershed protection efforts. Remember, your contribution will make a difference! Alzheimer’s Association Fund One in 10 Coloradans over 65 and nearly half over 85 have Alzheimer’s disease with 70% cared for at home. 100% of your donation to the Alzheimer’s Association will fund essential education, training, and counseling services to urban and rural families. Without support, the emotional burden on caregivers is tremendous. Colorado Cancer Fund Cancer touches every Coloradan as it is the leading cause of death in our state. Your donation to the Colorado Cancer Fund assists Coloradans through education, prevention, treatment, and support programs. The Colorado Cancer Coalition, collaborating with over 250 organizations, administers the fund to lead the fight against cancer. Make-A-Wish Foundation® of Colorado Fund Since 1983, Make-A-Wish Foundation® of Colorado has given hope, strength and joy to over 3,300 Colorado children with life-threatening medical conditions. As one of 65 chapters in the U.S., and 27 inter­ national chapters on five continents, Make-A-Wish Foundation® is the largest wish granting organization in the world. Unwanted Horse Fund Approximately 6,000 Colorado horses become unwanted each year because their owners no longer want them or can afford them. Abuse and abandonment are increasing whilst traditional outlets for unwanted horses—rescue facilities, therapeutic riding programs, etc., are reaching capacity. CUHA addresses the problem through grant programs, education initiatives and research. Urban Peak Housing and Support Services for Youth Experiencing Homelessness Fund Urban Peak provides shelter, supportive housing, street outreach, drop-in center services, education & employment training and other comprehensive support services to youths age fifteen through twenty-four who are experiencing homelessness in Colorado. Your contribution ensures that all Colorado youth have safe housing, supportive relationships and opportunities for self-sufficiency and success. Donate to a Colorado Nonprofit Fund For the first time ever, you can donate some or all of your state income tax refund to an eligible Colorado nonprofit of your choosing. It’s simple, fast, and puts you in charge of where your donation goes. Find the cause you’ll support here: dor-taxdonations.uc.r.appspot.com/.

Please read all instructions before completing the forms. STATE OF COLORADO DEPARTMENT OF REVENUE Official State of Colorado Publication PRSRT STD U.S. POSTAGE PAID DENVER CO PERMIT NO. 212 PAYMENT WITHOUT Mail To COLORADO DEPARTMENT OF REVENUE Denver, CO 80261-0005 PAYMENT WITH Mail To COLORADO DEPARTMENT OF REVENUE Denver, CO 80261-0006 MAILING ADDRESS FOR FORM DR 0104 These addresses and zip codes are exclusive to the Colorado Department of Revenue, so a street address is not required.

Full-Year, Part-Year and Nonresident Individuals Colorado Individual Income Tax Filing Guide Mailing Address For Form DR 0104 104 BOOK 2021 Booklet Includes: Instructions | DR 0104 | Related Forms Tax.Colorado.gov { { This book includes: yy DR 0104 2021 Colorado Individual Income Tax Form yy DR 0104EE Colorado Easy Enrollment Information Form yy DR 0104CH 2021 Voluntary Contributions Schedule yy DR 0900 2021 Individual Income Tax Payment Form yy DR 0104AD 2021 Subtractions from Income Schedule yy DR 0158-I 2021 Extension Payment for Colorado Individual Income Tax yy DR 0104PN Part-Year Resident/Nonresident Tax Calculation Schedule 2021 yy DR 0104US 2021 Consumer Use Tax Reporting Schedule yy DR 0104CR Individual Credit Schedule 2021 yy DR 0347 Child Care Expenses Tax Credit yy Disclosure of Average Taxes Paid yy Colorado Income Tax Table yy Description of Voluntary Contribution organizations With Payment These addresses and zip codes are exclusive to the Colorado Department of Revenue, so a street address is not required. Colorado Department of Revenue Denver, CO 80261-0006 Colorado Department of Revenue Denver, CO 80261-0005 Without Payment (01/18/22)

Page 2 Disclosure of Colorado Expenditures and Revenues Expenditures by Function Revenues by Source ** Due to rounding, the values in each chart may not sum to 100% Disclosure of Average Taxes Paid.............................. 2 Using this Guide: Filing Instructions........................... 3 Taxpayer Service and Assistance.............................. 9 Tax Table.................................................................. 17 DR 0104: Colorado Return for All Resident Types...... 19 DR 0104EE: Colorado Easy Enrollment Information Form....................................................... 23 DR 0104CH: Voluntary Contributions Schedule....... 25 DR 0104AD: Subtractions from Income Schedule... 27 DR 0900: Individual Payment Form......................... 29 DR 0158-I: Extension Information and Form............ 31 DR 0104PN: Part–Year Resident/Nonresident Tax Calculation Schedule......................................... 33 DR 0104US: Consumer Use Tax Reporting Schedule................................................. 37 DR 0104CR: Individual Credit Schedule.................. 39 DR 0347: Child Care Expenses Tax Credit.............. 45 Voluntary Contribution Information........................... 47 Table of Contents Disclosure of Average Taxes Paid by Income Group - 2018 $0 to $15,000 1 $15,000 to $29,999 $30,000 to $39,999 $40,000 to $49,999 $50,000 to $69,999 $70,000 to $99,999 $100,000 to $149,999 $150,000 to $199,999 $200,000 and more Average 2 Average State Taxes Paid Individual Income $90 $319 $762 $1,139 $1,667 $2,557 $4,040 $6,028 $18,136 $3,706 Sales and Use $329 $348 $507 $511 $580 $728 $939 $1,168 $2,704 $850 Gasoline $91 $99 $138 $154 $172 $203 $245 $264 $450 $201 Driver License and Vehicle Registration Fees $81 $111 $141 $149 $157 $179 $202 $217 $233 $164 Alcoholic Beverages $4 $3 $5 $6 $8 $9 $14 $18 $54 $13 Cigarettes and Tobacco $53 $48 $51 $58 $56 $58 $50 $41 $51 $52 Total State Taxes $648 $927 $1,605 $2,018 $2,640 $3,734 $5,490 $7,737 $21,629 $4,986 Average Local Taxes Paid Residential Real Property $839 $1,061 $1,326 $1,431 $1,629 $2,159 $3,139 $4,368 $12,597 $3,069 Sales and Use $525 $554 $807 $815 $925 $1,160 $1,496 $1,861 $4,308 $1,354 Specific Ownership 3 $114 $165 $215 $228 $241 $279 $317 $342 $368 $253 Occupational Privilege 4 $2 $5 $8 $10 $13 $18 $26 $37 $115 $25 Total Local Taxes $1,480 $1,784 $2,357 $2,484 $2,807 $3,617 $4,977 $6,609 $17,388 $4,701 Average Federal Taxes Paid Individual Income $621 $1,089 $2,005 $2,957 $4,592 $7,608 $12,856 $21,817 $95,989 $15,779 Medicare $115 $273 $423 $546 $722 $1,003 $1,433 $1,951 $3,599 $1,091 Social Security $493 $1,165 $1,807 $2,333 $3,086 $4,287 $6,128 $8,344 $9,636 $4,058 Total Federal Taxes $1,230 $2,527 $4,235 $5,836 $8,399 $12,897 $20,417 $32,113 $109,224 $20,928 Average Total Taxes Paid $3,357 $5,239 $8,197 $10,337 $13,846 $20,248 $30,885 $46,459 $148,240 $30,614 Average Total Taxes Paid by Employers 5 $441 $1,181 $1,988 $2,606 $3,466 $4,825 $6,920 $9,357 $11,050 $4,555 Sources: Colorado and Federal income tax return data and the Bureau of Labor Statistics’ Consumer Expenditure Survey (CES) Note: The values presented in this table are estimates because actual values are not known. Income and taxes paid were estimated using Colorado, federal, and third party data sources. The population is limited to full-year resident Colorado households that filed 2017 state and federal income tax returns. Income includes taxable and nontaxable income as well as transfer payments (such as public assistance, supplemental security income, and nutrition assistance). 1 Households estimated to have negative income are excluded from this table because we cannot estimate their taxes paid. Negative income is associated with self- employment, investment losses, and other losses. 2 The Average represents the total taxes paid divided by the total number of income tax returns. The Average was calculated for each row by multiplying the average tax paid for each income group by the number of returns in that income group, and then summing those values together and dividing by the total number of returns. 3 Specific ownership taxes are local property taxes on motor vehicles. 4 The occupational privilege tax is also known as the “head” tax. 5 Employers pay taxes to Medicare and Social Security on the employees’ behalf. This is distinct from the Medicare and Social Security taxes paid by individuals. Other 2.4% Taxes 32.9% Interest & Rents 2.1% Charges for Goods & Services 14.4% Federal Grants & Contracts 46.0% License, Permits & Fines 2.2% Other 8.1% Education 28.3% Justice 4.8% Transportation 3.8% Business, Community & Consumer Affairs 24.3% Social Assistance 30.6%

Page 3 How To Use This Filing Guide This filing guide will assist you with completing your Colorado Income Tax Return. Please read through this guide before starting your return. Once you finish the form, file it with a computer, smartphone or tablet using our free and secure Revenue Online service at Colorado.gov/RevenueOnline. You may also file using private e-File software or with a paid tax preparer. You significantly reduce the chance of errors by filing your return electronically. If you cannot file electroni- cally for any reason, mail the enclosed forms as instructed. All Colorado forms and publications referenced in this guide are available for download at Tax.Colorado.gov, the official Taxation website. The following symbols appear throughout this guide and point out important information, reminders and changes to tax rules.

This points out a topic that is the source of common filing errors. Filing your return on Revenue Online will reduce the risk of errors; however, it is important to understand the information on your return. Errors cause processing delays and erroneous bills.

Several subtractions and tax credits require you to provide supporting documentation. This symbol points out those requirements. If the additional documentation is not provided, it will cause processing delays or denial of the credits/ subtractions. These documents can be scanned and attached to your electronic filing through Revenue Online or most tax software, mailed with the DR 1778 or included with your paper return.

In-depth tax information is available in our easy to understand guidance publications, which include examples and worksheets. This symbol lets you know when such a publication is available for a subject. All guidance publications are available in the Tax Policy and Research section at Tax.Colorado.gov. Filing Information Who Must File This Tax Return Each year you must evaluate if you should file a Colorado income tax return. Generally, you must file this return if you are required to file a federal income tax return with the IRS for this year or will have a Colorado income tax liability for this year and you are: • A full-year resident of Colorado, or • A part-year Colorado resident who received taxable income while residing here (you must file the DR 0104 along with the DR 0104PN), or • Not a resident of Colorado, but received income from sources within Colorado (you must file the DR 0104 along with the DR 0104PN).

Colorado residents must file this return if they are required to file an income tax return with the IRS, even if they do not have a Colorado tax liability. Otherwise, the Department may file a return on your behalf and our return might not consider your unique tax situation. Also, the only way to determine if you are entitled to a refund is to file a return. Due Date The DR 0104 and any tax payment owed are due April 15, 2022. Revenue Online will accept returns as timely filed until midnight. Returns that are mailed must be postmarked by April 15. An automatic extension to file is granted until October 15, but there is no extension to pay. See page 31 for more information. If the due date falls on a weekend or federal holiday, return will be due the next business day. Deceased Persons Legal representatives and surviving spouses may file a return on behalf of a deceased person whose date of death was during the tax year. Surviving spouses may complete the return as usual and indicate the deceased status on the return. They can file the return and submit a copy of the death certificate through Revenue Online. Legal representatives may file the return and submit a copy of the death certificate through Revenue Online, but they must complete the Third Party Designee portion of the return. Either a surviving spouse or legal representative can avoid problems when filing on paper by marking the box next to the name of the deceased person, writing “DECEASED” in large letters in the white space above the tax year of the return, writing “FILING AS SURVIVING SPOUSE” or “FILING AS LEGAL REPRESENTATIVE” after their signature, and including the DR 0102 and a copy of the death certificate with the return.

To claim a refund on behalf of a deceased person: you must submit a copy of the death certificate with the DR 0102 when filing the return. Filing Status

You must file using the same filing status on both your federal and Colorado income tax returns. Any two individuals who legally file a joint federal income tax return must also file their Colorado income tax return jointly. Individuals filing a joint return must list the taxpayer names and Social Security numbers (SSN) in the same order on both the federal and Colorado returns. For married filing separately, do not list your spouse’s name or SSN on the return. Claiming Credits from a Pass-through Entity

Individuals claiming tax credits as a partner or shareholder must obtain from the partnership or S corporation a federal Schedule K-1 or other statement reporting the name and employer identification number (EIN) of the partnership or S corporation and the type and amount of the credit. The Colorado Department of Revenue verifies the credit claims of partners and shareholders by reviewing the partnership or S corporation’s return. The Schedule K-1s or statements may be submitted through Revenue Online, through tax software or may be included with a paper return.

Page 4 Line–by–Line Instructions for the DR 0104 First, complete the federal income tax return you will file with the IRS. You will use information from that return on your Colorado income tax return. Colorado income tax is based on your federal taxable income, which has already considered your deductions. Residency Status Mark the appropriate box to designate your residency status. If you are filing a joint return, and one person is a full-year Colorado resident and the other is either a part-year resident or a nonresident, mark the Part-Year Resident/Nonresident box. Part-Year Colorado Residents and Nonresidents Tax is prorated so that it is calculated only on income received in Colorado or from sources within Colorado. We recommend you review Income Tax Topics: Part-Year Residents & Nonresidents if this applies to you. You will calculate your prorated tax by completing the DR 0104PN. You must submit the DR 0104PN along with the DR 0104. Persons Traveling or Residing Abroad If you are traveling or residing outside the United States on April 15, the deadline for filing your return is June 15, 2022. If you need additional time to file your return, you will automatically have until October 15, 2022, to file. Interest is due on any tax paid after April 15, 2022. To avoid any late payment penalties, you must pay 90% of your tax liability by April 15, 2022, file your return by October 15, 2022 and pay any remaining tax due at the time of filing. If the due date falls on a weekend or federal holiday, return will be due the next business day. When filing your return, mark the “Abroad on Due Date” box on Revenue Online or the paper return. Active Duty Military Under federal law, a military servicemember’s state of legal residence does not change solely as the result of the service- member’s assignment for service in another state. Consequently, a Colorado resident who enters into military service will remain a Colorado resident unless they officially change their state of legal residence as described in DD Form 2058. In general, military servicemembers who are Colorado residents are subject to the same income tax filing requirements as other Colorado residents, even if they are serving in another state. These requirements are described on the preceding page, under the heading “Who Must File This Tax Return.” However, any military servicemember who spends at least 305 days of the tax year stationed outside of the United States on active military duty may elect to be treated as a nonresident. The servicemember may make this election by filing a return and checking the applicable box on Form 104PN. Military servicemembers who are stationed in Colorado, but are not Colorado residents, are not required to pay Colorado tax on their military income. However, any other Colorado source income of a nonresident servicemember is subject to Colorado taxation. Please see Tax.Colorado.gov/military-servicemembers for additional information.

The residency rules described above for military servicemembers also apply generally to a servicemember’s spouse if the spouse is residing with the servicemember either inside or outside of Colorado in compliance with the servicemember’s military orders. If a servicemember and their spouse are nonresidents stationed in Colorado, any wages earned by the spouse for work performed in Colorado are not subject to Colorado taxation. The military spouse must complete a DR 1059, provide a copy to their employer when hired for employment, and submit a copy to the Department, along with a copy of their military ID card, when they file their Colorado return each year. The DR 1059 may be filed with the Department through Revenue Online, with DR 1778, or included with a DR 0104 filed by paper. Name and Address Provide your name, mailing address, date of birth, Social Security number and the state of issue, the last four digits, and the date of issuance of your state issued ID card in the provided spaces. If filing Married Filing Jointly, provide the spouse’s information where prompted. Provide the spouse’s information ONLY if filing a joint return. Otherwise leave blank. All Departmental correspondence will be mailed to the mailing address provided. We recommend you read publication FYI General 2 for the Privacy Act Notice. Colorado Health Coverage Easy Enrollment Colorado taxpayers can now share certain information from their state tax return with the Colorado Health Benefit Exchange (Connect for Health Colorado) and the Colorado Department of Health Care Policy & Financing to find out if they qualify for free or reduced-cost health coverage (Colorado Law: 39-21-113(25) C.R.S). If you give your permission, the Department of Revenue will share only the information on form DR 0104EE which includes: • Name and date of birth for you, your spouse, and everyone listed on your taxes as your dependent (your tax household). • Social Security Number or Tax ID for you, your spouse, and everyone listed on your taxes as your dependent. You may choose to not provide Social Security Numbers. • Your address, phone number, and email address so we can contact you. • Your income. • Whether you filed your return electronically or on paper. This information will only be used to check if you can enroll in health coverage and qualify for help paying for coverage. For more information about getting health coverage, visit Connect for Health Colorado at https://connectforhealthco.com. To see if you or members of your household qualify for free or reduced-cost health coverage, check this box if: • At least one person in your household does not have health coverage AND

Page 5 • You give permission for the Colorado Department of Revenue to share the information on Form DR 0104EE with Connect for Health Colorado (the Colorado Health Benefit Exchange) and the Department of Health Care Policy & Financing. To share your information, complete form DR 0104EE. If you are using software to complete your tax return, the software may autofill the form for you. Check it to make sure it is accurate and complete. If you are filing a paper return, complete the DR 0104EE and include it with your return. Line–by–Line Instructions for the DR 0104EE Section A: Household Contact Information Complete this information so Connect for Health Colorado can contact you to help you enroll in health coverage. Make sure your name, phone number, email address, and mailing address are correct and complete. Section B: Household Member and Income Information Complete this information so Connect for Health Colorado can check if you or members of your household qualify for free or reduced-cost health coverage. Your household includes yourself, your spouse, and any person that you claim as a tax dependent on your federal income tax return. Dependents are usually children who live with you but may include other relatives you support financially. Line 1: Enter your tax household size here. Include yourself, your spouse, and anyone you claim as a dependent on your federal income tax return. Line 2: Enter your adjusted gross income here. Adjusted gross income is found on line 11 of your federal tax form 1040, 1040-SR, or 1040-NR. Line 3: Enter information about yourself, your spouse, and/or dependents for each member of your tax household in the table below. Line 1 Federal Taxable Income Refer to your federal income tax return to complete this line: • Form 1040, 1040SR, 1040NR, or 1040SP line 15 If your federal taxable income is a negative amount, be sure to enter the amount as such on your Colorado return. If submitting a paper return, put the negative amount in parentheses, for example ($1,234).

Do not enter your total income or wages on this line because it will make your tax too high. The Department will compare the amount you list here to the return you file with the IRS, so be very careful to complete this correctly. Additions Line 2 State Addback Refer to your federal income tax return to complete this line. Enter $0 if you filed Form 1040, 1040SR, or 1040SP but did not itemize your deductions on Schedule A. Taxpayers who deduct general sales taxes on Schedule A line 5a, Form 1040, 1040SR, or 1040SP, are not required to calculate this addback. If you deducted state income tax on Schedule A line 5a, complete the worksheet below to calculate the Income Tax Deduction.

We recommend that you read the Individual Income Tax Guide for special instructions before completing the worksheet below. Complete the following worksheet to determine your state income tax deduction addback. a) Is the amount on federal 1040, 1040SR, or 1040SP Schedule A line 5d greater than the amount on federal Form 1040, 1040SR, or 1040SP Schedule A line 5e? $ No. Enter the state income tax deduction from federal Form 1040, 1040SR, or 1040SP Schedule A line 5a. Yes. Subtract the amounts on federal Form 1040, 1040SR, or 1040SP Schedule A lines 5b and 5c from the amount on line 5e. Enter the result, but not less than $0. b) Total itemized deductions from federal Form 1040, 1040SR, or 1040SP Schedule A line 17 $ c) The amount of federal standard deduction you could have claimed (See instructions federal Form 1040, 1040SR, or 1040SP line 12a for 2021 federal standard deductions.) $ d) Line (b) minus line (c), but not less than $0 $ Transfer to line 2 of the DR 0104 the smaller amount from line (a) or (d) of the worksheet above. Line 3 Qualified Business Income Deduction Addback Taxpayers who claimed a deduction for qualified business income under section 199A of the Internal Revenue Code are required to add to federal taxable income an amount equal to that deduction if the taxpayer’s adjusted gross income is greater than $500,000 ($1,000,000 if filing jointly). This addback does not apply to a taxpayer who is required to file a federal Schedule F, Profit or Loss From Farming, with their federal income tax return. Line 4 Other Additions Enter the sum of the following and specify which addition(s) in text box: • Bond interest—the amount of any interest earned from bonds issued by any state or political subdivision, excluding any bonds issued by the State of Colorado or its political subdivisions on or after May 1, 1980. Calculate the appropriate amount by subtracting the amortization of bond premiums and expenses (required to be allocated to interest income by Internal Revenue Code) from the gross amount of state and local bond interest. We recommend that you read the Individual Income Tax Guide if this applies to you.

Page 6 • Improper distributions from a qualified state tuition program for which tuition program contribution subtraction was previously claimed. See FYI Income 44 for additional information. • Charitable gross conservation easement—the amount of your federal charitable deduction for a conservation easement that is also claimed for a Colorado tax credit. Complete the DR 1305 Part D. • Alien labor—the amount of expenses for unauthorized alien labor services. We recommend that you read the Individual Income Tax Guide if this applies to you. • Partnership/Fiduciary—the amount of any fiduciary adjustment or partnership modification that increases your federal taxable income. • Any expenses incurred by a taxpayer with respect to expenditures made at, or payments made to, a club that restricts membership on the basis of sex, sexual orientation, marital status, race, creed, religion, color, ancestry or national origin. • Distributions from a medical savings account not made for an eligible expense. Line 5 Subtotal Enter the sum of lines 1 through 4. Line 6 Subtractions from the DR 0104AD Schedule, line 20 Transfer the amount from the DR 0104AD line 20 to report any subtractions from your Federal Taxable Income. These subtractions will change your Colorado Taxable Income from the amount of Federal Taxable Income. See instructions in the income tax booklet for additional guidance on completing this schedule. Do not enter negative amounts. To ensure faster processing of your paper return, the amount entered on line 6 must exactly match the amount on the DR 0104AD. You must submit the DR 0104AD with your return. Line 7 Colorado Taxable Income Subtract line 6 from line 5. This is your Colorado taxable income and is the figure used to determine how much Colorado tax is owed, if any. Part-Year Residents or Nonresidents Go To the DR 0104PN. Full-Year Residents Continue To Line 8 Line 8 Colorado Tax The income tax rate is currently 4.5%. Full-year residents should refer to the tax table in this booklet. Determine the tax by the amount listed on line 7. Part-year residents and nonresidents should transfer the apportioned tax amount from the DR 0104PN line 36. You must submit the DR 0104PN along with the DR 0104. Line 9 Alternative Minimum Tax Enter the amount of any Alternative Minimum Tax. Generally, if you pay alternative minimum tax on your federal income tax return, you will pay the same for your Colorado return. We recommend that you read the Individual Income Tax Guide if this applies to you. Line 10 Recapture of Prior Year Credits Enter any credit claimed in prior years that is subject to recapture under Colorado law. Line 11 Subtotal Sum of lines 8 through 10. Tax Credits Visit Tax.Colorado.gov/Income-Tax-Credits to read more about which tax credits can be claimed on this form. Line 12 Nonrefundable Credits Complete the DR 0104CR to claim various nonrefundable credits. Transfer the amount from the DR 0104CR line 43 to this line. The nonrefundable credits used from the DR 0104CR combined with the total Nonrefundable Enterprise Zone Credit used cannot exceed line 11. To ensure faster processing of your paper return, the amount entered on line 12 must exactly match the amount on the DR 0104CR. You must submit the DR 0104CR with your return.

Scan and submit any required documentation through Revenue Online E-Filer Attachment, attach to your electronic return or mail paper documentation with the DR 1778 E-Filer Attachment. Line 13 Nonrefundable Enterprise Zone Credits Use your tax software, Revenue Online or the DR 1366 to calculate the total amount of Nonrefundable Enterprise Zone Credits being used to offset the current year tax liability. Complete the DR 1366 and transfer line 84 to this line. The total Nonrefundable Enterprise Zone Credit used combined with nonrefundable credits from the DR 0104CR cannot exceed the amount on line 11. You must submit the DR 1366 and a copy of each certificate with your return.

The Department strongly recommends electronic filing for taxpayers with enterprise zone credits. Failure to file electronically may result in delays processing your return. Line 14 Strategic Capital Tax Credits Use your tax software, Revenue Online or the DR 1330 to calculate the total amount of nonrefundable Strategic Capital Tax Credits being used to offset the current year tax liability. Complete the DR 1330 and transfer amount on line 7b to this line. The total nonrefundable Strategic Capital Tax Credits used combined with nonrefundable credits from lines 12 and 13 cannot exceed the amount on line 11. You must submit the DR 1330 and a copy of each certificate with your return. The Department strongly recommends electronic filing for taxpayers with Strategic Capital Tax credits. Failure to file electronically may result in delays processing your return.

Please include a copy of each Strategic Capital Tax Credit Certificate Line 15 Net Income Tax Sum of lines 12, 13, and 14. Subtract that sum from line 11. This cannot be a negative number.

Page 7 Line 16 Use Tax Enter the amount from the DR 0104US schedule line 7. If you do not owe any use tax, then leave this line blank and DO NOT fill out the DR 0104US schedule. For more information on your consumer use tax obligation, including how to use the new annual customer reports from non-collecting retailers, please visit Tax.Colorado.gov/Consumer-Use-Tax. If you are reporting use tax on this return, you must submit the DR 0104US with your return. Line 17 Net Colorado Tax Sum of lines 15 and 16. Line 18 Colorado Income Tax Withheld Enter the sum of all Colorado income tax withheld as reported on W-2, W-2G and/or various 1099 statements.

Enclose your Colorado withholding forms where indicated or, if filing electronically, scan and submit them through Revenue Online E-Filer Attachments.

Failure to submit your withholding forms will result in the credit being denied. Do NOT include withholding for federal income tax, income tax from another state, or income tax from local governments. Be certain to exclude amounts withheld from Colorado real estate sales by nonresidents, nonresident beneficiary withholding, or Colorado partnership or S Corporation income withholding for nonresidents because these specified amounts should be listed on line 22. Line 19 Prior-year Estimated Tax Carryforward Enter the amount, if any, from your 2020 Colorado DR 0104 line 31. Line 20 Quarterly Estimated Payments Carefully review your payment(s) before completing this line. Use Revenue Online (Colorado.gov/RevenueOnline) to verify estimated taxes paid on your account. Doing so will reduce processing delays. Most taxpayers who have made quarterly estimated payments used the DR 0104EP to remit these payments. Refer to the Individual Income Tax Guide for more information about Estimated Payments. Line 21 Extension Payment Enter the amount, if any, you remitted with the DR 0158-I to ensure 90% of your tax was paid by the filing due date. Line 22 Other Prepayments Enter the sum of payments remitted on your behalf because you received Colorado income from: • an estate as a beneficiary – remitted using the DR 0104BEP, and/or • partnership or shareholder agreement–remitted using the DR 0108, and/or • a real estate transaction that closed during the tax year for which you are filing this return – remitted using the current DR 1079. Be sure to mark corresponding box(es) as appropriate. Line 23 Gross Conservation Easement Credit Complete all applicable parts of the DR 1305. Enter the amount from the DR 1305G line 33. You must submit the DR 1305G with your return. Line 24 Innovative Motor Vehicle and Innovative Truck Credit Complete one Form DR 0617 for each vehicle, truck, trailer, or modification claimed, then enter the amount (or sum) from each DR 0617 line 9 and/or line 18. You must submit each DR 0617 with your return. NOTE: If you assigned the credit to a financing entity you will not submit a Form DR 0617. For additional information, please refer to FYI Income 69.

For each Form DR 0617, you must also submit copies of the title, purchase invoice, lease agreement, or conversion receipts, along with proof of permanent Colorado registration for each vehicle for which you are claiming a credit. For financing entities that accept assignment of the credit, a completed Form DR 0618 must be submitted for each vehicle claimed. Line 25 Refundable Credits Complete the DR 0104CR to claim various refundable credits. Transfer the amount from the DR 0104CR line 9 to this line. You must submit the DR 0104CR with your return.

See the DR 0104CR for the required documentation for the credit claimed. Submit using Revenue Online, attach to an electronically filed return as a PDF or include with your paper return. Line 26 Subtotal Sum of lines 18 through 25. Lines 28 through 30 are only used to calculate your TABOR credit, they do not affect your Colorado tax liability. Line 27 Federal Adjusted Gross Income Refer to your 2021 federal income tax return to complete this line: • Form 1040, 1040SR, 1040NR, or 1040SP line 11 If your federal adjusted gross income is a negative amount, be sure to enter the amount as such on your Colorado return. If submitting a paper return, put the negative amount in parentheses, for example ($1,234). Line 28 Nontaxable Social Security Income Refer to your 2021 federal income tax return to complete this line. Subtract the amount on line 6b of Form 1040, 1040SR, or 1040SP from line 6a and enter that amount here. Line 29 Nontaxable Lump-sum Distributions from pension and profit sharing plans Refer to the DR 0104 line 4. If you entered any lump-sum distributions on line 4 that were reported to the IRS on federal form 4972, excluding any estate tax paid, enter the amount of lump-sum distributions here. Line 30 Nontaxable Interest Income from State and Local Bonds Refer to the DR 0104 line 4. If you entered any bond interest on line 4, enter the amount of bond interest income here. Line 31 Modified AGI for TABOR This line is automatically calculated by Revenue Online. If filing a paper return, enter the sum of lines 27 through 30.

Page 8 Line 32 State Sales Tax Refund Full-year Colorado residents who made their home in Colorado and were age 18 or older for the entire year of 2021 are eligible to receive the State Sales Tax Refund. Full-year residents who were under the age of 18 qualify for the refund only if they are required to file a Colorado return because of a federal requirement to file or to obtain a refund of wage withholding. Part-year and nonresidents do not qualify for this refund. Individuals incarcerated in either a Department of Corrections owned or operated facility or a county or municipal jail for 180 days may not be eligible for the refund. A person under the age of 18 who would have been convicted of a felony as an adult and committed to the Department of Human Services may not be eligible for the credit. In order to qualify, your return must be postmarked by April 15, 2022 or October 15, 2022 if you are filing an extension. If the due date falls on a weekend or federal holiday, your return must be postmarked by the next business day. To determine the credit available to you, refer to the amount you entered on line 31 and your filing status. Find the appropriate amount in the table that accompanies line 32 and enter the amount on line 32. Line 33 Sum of Lines 26 and 32 Enter the sum of line 26 (Subtotal) and line 32 (State Sales Tax Refund). Compare lines 17 and 33. If line 17 is greater, skip to line 37. If line 33 is greater, continue to line 34. Line 34 Overpayment Subtract line 17 from line 33. Line 35 Estimated Tax Carryforward Enter the amount, if any, you would like to be available for 2022 estimated tax. Line 36 Refund Subtract line 35 from line 34. This is the amount of your refund. You have the option of authorizing the Department to directly deposit these funds to your bank or CollegeInvest account. Otherwise, a refund check will be mailed to the address you have designated on this return. • Direct Deposit—Enter the routing and account numbers and account type. The routing number is 9 digits. Account numbers can be up to 17 characters (numbers and/or letters). Include hyphens, but do NOT enter spaces or special symbols. We recommend that you contact your financial institution to ensure you are using the correct information and that they will honor a direct deposit. See the sample check below to assist you in finding the account and routing numbers.

Did you know you can now direct deposit your tax refund into a new or existing CollegeInvest account? Please contact 1-800-448-2424 or visit CollegeInvest.org for more information. • Intercepted Refunds—The Department will intercept your refund if you owe back taxes or if you owe a balance to another Colorado government agency or the IRS. If you are filing a joint return and only one party is responsible for the unpaid debt, you may file a written claim to: Colorado Department of Revenue, Injured Spouse Desk, PO Box 17087, Denver, CO 80217-0087. Claims must include a copy of your federal income tax return, federal form 8379 and copies of all W-2, W-2G, or any 1099 statements received by both parties. DO NOT include your claim with this return. It will not be processed. Line 37 Net Tax Due Subtract line 33 from line 17. This is the amount you owe with this return. If you are filing after the due date (or valid extension) or you owe estimated tax penalty, continue to the next line. If you are filing timely and do not owe penalty or interest, go to line 41. Line 38 Delinquent Payment Penalty Calculate any penalty owed for delinquent filing or payment. The penalty is the greater of $5 or 5% of the net tax due for the first month after the due date and increased by 0.5% for each additional month past the due date. The maximum penalty is 12%. If you prefer not to calculate this penalty, the Department will bill you. Line 39 Delinquent Payment Interest Calculate any interest owed for delinquent filing or payment. The interest rate is 3% of the net tax due. If you prefer not to calculate this interest, the Department will bill you. Interest on any bill issued that remains unpaid after 30 days of issuance will increase to 6%. Line 40 Estimated Tax Penalty To calculate this penalty, complete the form DR 0204. Enter any estimated tax penalty owed on this line. You must submit the DR 0204 with your return. If you over compute your estimated tax penalty from what the Department calculates, any amount of overpayment of penalty will be refunded to you.

Scan and submit the form DR 0204 through Revenue Online E-Filer Attachments or submit the form with your paper return. Line 41 Amount You Owe Enter the sum of lines 37 through 40. Please note: Any assessment made by the Department will likely include delinquent payment penalty and interest. The only way to avoid paying penalty and interest is to pay in full by the filing due date. You have three payment options: • Pay Online—After submitting your return on Revenue Online, you will be given the opportunity to submit an online payment with your credit card, e-check or by Electronic Funds Transfer (EFT). A nominal processing fee may apply. If you file a paper return, you may still choose to pay electronically. Visit Colorado.gov/RevenueOnline for details.

Page 9 • Pay by Mail—If filing by Revenue Online or other electronic filing method and you wish to send a check or money order, complete the form DR 0900 and mail with your payment. Make payable to “Colorado Department of Revenue” and clearly write your Social Security number and “2021 DR 0104” on the memo line. Be sure to keep a copy of the money order or note the check number with your tax records. • Payment Plan—The Department will issue a bill for any unpaid balance due. When you receive the bill, you may set up a payment plan as instructed on the bill. Third Party Designee Mark the “Yes” box to appoint the person entered on your return as the designee to receive and inspect confidential tax information related to this tax return. If a firm or organization is listed, this tax information authorization will apply to any of its employees. The designee may: • call the Department for information about the return, including processing time and refund status; • request copies of notices, bills or transcripts related to the return; and • respond to inquiries regarding calculations and supporting documentation for the return. However, a designee cannot sign any form or protest, request any other change to the account, receive any refund, or otherwise represent or act on behalf of the taxpayer with the Colorado Department of Revenue. This authorization expires four years after the date the return is signed. A taxpayer may change or revoke it, or an appointee may withdraw from it. For more information, see the instructions for form DR 0145, Tax Information Authorization or Power of Attorney. W-2s and 1099s

When filing a paper return, all W-2s and/or 1099s that show Colorado income tax withholding must be included with the form. When filing an electronic return, attach scanned copies of all W-2s and/or 1099s that show Colorado income tax withholding to the e-filed tax return. If you are unable to attach W-2s and/or 1099s to your e-filed return, submit through Revenue Online, Colorado.gov/RevenueOnline. Taxpayer Service and Assistance Revenue Online and Secure Messaging The Department offers many services through Revenue Online. You can file or amend a return, submit required return attachments, monitor your account activity, pay taxes, check the status of a refund, file a protest and send a secure message to Department staff. Visit Colorado.gov/RevenueOnline to get started. Taxation Website Visit the official Colorado Department of Revenue’s Taxation Division website, Tax.Colorado.gov, for tax forms, guidance publications, education resources, legal research and more. Call Center Representatives are available Monday through Friday, 8 a.m. to 4:30 p.m. 303-238-SERV (7378) TTY/TDD 800-659-2656 Taxpayer Service Centers All visits for assistance and information can be scheduled at our webpage at Tax.Colorado.gov/Visit-a-Service-Center. Forms are available Monday through Friday, 8:00 am to 4:30 pm. For those who do not need assistance, each service center is equipped with a secure drop box for documents. Denver Metro—1881 Pierce Street, Entrance B, Lakewood, CO Colorado Springs—2447 North Union Boulevard Fort Collins—3030 South College Avenue Grand Junction—222 South 6th Street, Room 208 Pueblo—827 West 4th Street, Suite A

Page 10 Did Not Receive W-2 Statement from Your Employer • Contact your employer to request a copy, or • Use the year-to-date (YTD) Colorado wages and withholding amounts from your final paycheck stub to complete a Substitute W-2, form DR 0084. Submit both the final paycheck stub and DR 0084 with your return. Records Retention Keep all documentation you used to prepare your return at least 4 years after the due date, which is the statute of limitations for the Department to make changes to your return. However, if the Department does not receive your return, they may file on your behalf using the best information available. There is no statute of limitations for assessment if a return is not filed. Correcting Errors or Changing a Return Individual income tax returns from 2009 and forward may be amended electronically through Revenue Online. Filing and amending returns in Revenue Online is a free service. You may amend online even if the original return was filed on paper. Revenue Online has all the information from your original return. You will not need to re-enter everything. • If you cannot amend online, you may file the DR 0104X. Make sure you use the appropriate form version for the year you are amending. • If you are changing your Colorado return because the IRS made changes to your federal return, you must file the DR 0104X within 30 days of being notified by the IRS. You must amend your Colorado return in this case, even if there is no net change to your tax liability.

IT IS VERY IMPORTANT THAT YOU SUBMIT ALL SCHEDULES AND SUPPORTING DOCUMENTATION FOR ANY CHANGES WITH YOUR AMENDED RETURN. YOU MUST SUBMIT ALL SCHEDULES, EVEN IF YOU ARE NOT CHANGING THOSE VALUES. Estimated Tax Requirements If you expect next year’s Colorado tax liability to be greater than $1,000 after subtracting credits, you should make estimated tax payments using the DR 0104EP. We recommend that you read the Individual Income Tax Guide for additional information. Filing Errors and Incomplete Information It is important to read all the information available for your specific tax situation and to submit all required documentation with your return. Failure to do so may result in delayed processing of your return and refund, if any. We recommend that you file using Revenue Online to avoid common mathematical errors. You may also opt to use a commercial tax preparation software program or a paid tax professional to help you complete your return. Federal Earned Income Tax Credit and Colorado Insurance Programs Individuals with lower income and/or those who have qualifying children may be eligible for a refund resulting from the federal and/or state Earned Income Tax Credit (EITC), the federal Child Tax Credit, and/or low-cost health insurance through Child Health Plan Plus (CHP+). You may obtain additional information regarding the federal EITC online at IRS.gov or by calling Colorado United Way at 211. Additional information regarding CHP+ may be found at CCHP.org or by calling 1-800-359-1991. Common Issues

Page 11 If you use this schedule to claim any subtractions from your income, you must submit it with the DR 0104. Line 1 State Income Tax Refund Refer to your federal income tax return to complete this line. If you did not complete federal Schedule 1, Form 1040, 1040SR, 1040NR, or 1040SP, enter $0. Otherwise, enter the amount from line 1, Schedule 1, Form 1040, 1040SR, 1040NR, or 1040SP. Line 2 U.S. Government Interest Enter the sum of all interest earned from U.S. government bonds, treasury bills and other obligations of the U.S. or its territories, possessions and agencies that you reported on your federal income tax return and is calculated as part of your federal taxable income. We recommend that you read the Individual & Corporate Income Tax Guides if this applies to you.

Do not include interest earned from Federal National Mortgage Association and Government National Mortgage Association (Fannie Mae and Ginnie Mae). Dividends from mutual funds may not be 100% exempt. Line 3 Pension and Annuity Subtraction You might be eligible to subtract the income you earned from a pension or annuity. We recommend that you read publication FYI Income 25 if this applies to you. This subtraction is allowed only for pension or annuity income that is included in your federal taxable income. The amount of subtraction you can claim is also limited based upon your age. As of December 31, 2021, if you were: • Age 65 or older, then you are entitled to subtract $24,000 or the total amount of your taxable pension/ annuity income, whichever is smaller; or • At least 55 years old, but not yet 65, then you are entitled to subtract $20,000 or the total amount of your taxable pension/annuity income, whichever is smaller; or • Younger than 55 years old and you received pension/annuity income as a secondary beneficiary (widow, dependent child, etc.) due to the death of the person who earned the pension/annuity, then you are entitled to subtract $20,000 or the total amount of your secondary beneficiary taxable pension/annuity income, whichever is smaller. If this applies to you, please list the Social Security number of the deceased in the space provided.

Pension/annuity income should not be intermingled between spouses. Each spouse must meet the requirements for the subtraction separately and claim the subtraction only on their pension/annuity income. Any qualifying spouse pension/annuity income should be reported on line 4.

Submit copies of all 1099R and SSA-1099 statements with your return. Submit using Revenue Online or include with your paper return. Line 4 Spouse Pension and Annuity Subtraction If the secondary taxpayer listed on a jointly filed return is eligible for the pension and annuity subtraction, enter the qualifying amount on this line. Review the instructions for line 3 to see what amount qualifies. We recommend that you read publication FYI Income 25 if this applies to you.

Take precautions to report the subtraction on the correct line. The first person listed on the return shall report on line 3 and the second person listed shall report on line 4. Line 5 Military Retirement Subtraction You might be eligible to subtract the income you earned from your military retirement benefits. We recommend that you read publication Income Tax Topics: Military Servicemembers if this applies to you. This subtraction is allowed only for military retirement income that is included in your federal taxable income. To qualify, you must have been 54 years of age or younger as of December 31,2021. If you meet the age requirement, then you are entitled to subtract $10,000 or the total amount of your taxable military retirement benefits, whichever is smaller.

Military retirement benefits should not be intermingled between spouses. Each spouse must meet the requirements for the subtraction separately and claim the subtraction only on their military retirement benefits. Any qualifying spouse military retirement benefits should be reported on line 6.

Submit copies of all 1099R statements with your return. Submit as attachments when e-filing or using Revenue online, or include with your paper return. Line 6 Spouse Military Retirement Subtraction If the secondary taxpayer listed on a jointly filed return is eligible for the military retirement subtraction, enter the qualifying amount on this line. Review the instructions for line 5 to see what amount qualifies. We recommend that you read publication Income Tax Topics: Military Servicemembers if this applies to you.

Take precautions to report the subtraction on the correct line. The first person listed on the return must report on line 5 and the second person listed must report on line 6. Line 7 Colorado Capital Gain Subtraction You might be eligible to subtract some or all of the capital gain included in your federal taxable income, if the gain is derived from the sale of tangible personal property or from the sale of real property located in Colorado. The amount of this subtraction is limited to $100,000. We recommend that you read Income Tax Topics: Colorado Capital Gain Subtraction if this applies to you.

You must complete and submit the DR 1316 with your return. Take precaution to completely fill out each item of this form. Be as detailed as possible, especially when providing property descriptions, ownership, and dates of acquisition and sale. Line–by–Line Instructions for the DR 0104AD - Subtractions from Income Schedule

Page 12 Line 8 CollegeInvest Contribution Contributions to CollegeInvest can be deducted from your return. The contribution must have been included on your federal income tax return and calculated as part of your federal taxable income. We recommend that you read publication FYI Income 44 if this applies to you.

The three fields on line 8 should be left blank if the taxpayer and/or spouse are the CollegeInvest account owners who set up the account for the student beneficiary. If you are not the account owner (e.g. grandparent, friend), complete the three additional fields. To report contributions to more than one account, you must file electronically. Do not deduct contributions made to a tuition savings plan for another state or any tuition you paid while attending school.

Do NOT deduct contributions made by your employer/business to your College Invest account on this line. To claim pass-through credits for employer contributions to employee 529 qualified state tuition account, please refer to the instructions on form DR 0289 and report the credit on applicable credit schedule. Line 9 Qualifying Charitable Contributions Taxpayers who make charitable contributions that would be eligible for a federal income tax deduction, but do not claim federal itemized deductions on Schedule A of form 1040, 1040SR, 1040NR, or 1040SP, might be eligible to deduct a portion of their contribution on this form. We recommend that you read publication Income Tax Topics: Charitable Contributions if this applies to you. Use the worksheet on the next page to determine your qualifying contribution. (a) Did you itemize your deductions on Schedule A of federal form 1040, 1040SR, 1040NR, or 1040SP? Yes No (b) Did you deduct charitable contributions on the federal form? Yes No If you answered Yes on either (a) or (b) above, enter $0 on line 9; you do not qualify for this subtraction. If you answered No on both (a) and (b) above, continue below. (c) Enter the amount you could have deducted as charitable contributions on lines 11 and 12 of federal Schedule A (lines 2 and 3 on Schedule A of federal form 1040NR). $ (d) Colorado adjustment $500 (e) Subtract line (d) from line (c). This is the qualifying amount. If the amount is greater than $0, transfer to line 9. Enter the total contributions in the space provided and the subtraction after the $500 adjustment on line 9.

Do not enter an amount on this line if you already deducted your charitable donation on Schedule A of the federal form 1040, 1040SR, 1040NR, or 1040SP. Otherwise, you will be issued an assessment that will likely include penalty and interest.

For claims greater than $5,000, submit the receipts you received at the time of donation. For in-kind donations, submit an itemized list of the donated items and their fair market value. Submit using Revenue Online or include with your paper return. Do not send receipts of items that were purchased for donation. Line 10 Qualified Reservation Income List any amount of income that was derived wholly from reservation sources by an enrolled tribal member who lives on the reservation, which was included as taxable income on the Federal income tax form.

Submit proof of tribal membership, residence, and source of income. This must be submitted every three years by taxpayers claiming this subtraction. Line 11 PERA/DPSRS Subtraction If you made contributions to PERA between July 1, 1984, and December 31, 1986, or to Denver Public Schools District No. 1 Retirement during 1986 and your 2021 federal taxable income includes pension income, see FYI Income 16 to determine if you can take a subtraction for any of your pension income.

Submit a copy of your previously taxed contribution. PERA statements can be obtained from Copera.org or by calling 1-800-759-7372. Submit using Revenue Online or include with your paper return.

Do not list the amount of contributions you made as an employee this past year. Line 12 Railroad Benefit List any railroad retirement benefits that you reported on your federal income tax return and is calculated as part of your federal taxable income. We recommend that you read publication FYI Income 25 if this applies to you.

Submit copies of all RRB-1099 and RRB-1099R Statements. Submit using Revenue Online or submit with your paper return. Line 13 Wildfire Mitigation Measures Enter the amount incurred in performing wildfire mitigation on your land, up to $2,500. We recommend that you read publication FYI Income 65 to properly calculate this subtraction.

Submit copies of receipts for qualified costs for wildfire mitigation for your property. Submit using Revenue Online or submit with your paper return. Line 14 Colorado Marijuana Business Deduction For Colorado-licensed marijuana businesses, list any expenditure that is eligible to be claimed as a federal income tax deduction but is disallowed by section 280E of the Internal Revenue Code because marijuana is a controlled substance under federal law. To calculate this deduction, you must create pro forma federal schedule(s) for Business Profit or Loss as if the federal government would have allowed the expenditures from the marijuana business. The Colorado deduction shall be the difference between the profit/loss as calculated on the

Page 13 ACTUAL schedule(s) filed with the federal return and the pro forma schedule(s) described above.

You must submit the pro forma schedule(s), the MED license number and the actual federal schedule(s) with your Colorado return when claiming this deduction. Submit using Revenue Online or submit with your paper return. Line 15 Nonresident Disaster Relief Worker Subtraction For nonresident individuals, enter the amount of compensation earned for performing disaster-related work in the state during a declared state disaster emergency and for the 60 days thereafter. Disaster-related work includes repairing, renovating, installing, building, or rendering services that relate to infrastructure that has been damaged, impaired, or destroyed by a declared state disaster emergency or providing emergency medical, firefighting, law enforcement, hazardous material, search and rescue, or other emergency service related to a state declared disaster emergency. Enter the executive order number(s) from the Colorado governor’s office that declared the state disaster emergency in format “D YYYY-###.”

This subtraction is only available to nonresident individuals. If you are a full-year resident of Colorado, you are not eligible for this subtraction. Line 16 Reacquisition of Colorado Residency During Active Duty Military Service Subtraction This subtraction is only allowed to military servicepersons who meet several requirements. In order to qualify for the subtraction the serviceperson must (1) have Colorado as his or her home of record, (2) after enlisting in the military, have acquired legal residency in a state other than Colorado, and (3) on or after January 1, 2016, have reacquired Colorado residency. A military serviceperson who meets these three requirements can claim a subtraction for any compensation included in his or her federal taxable income that he or she received for active duty service after reacquiring Colorado residency. In order to have acquired residency in another state, you must have: 1. been physically present in that state, 2. intended to make that state your permanent home, and 3. intended to abandon your previous state of legal residence. In order to reacquire residency in Colorado, you need not be physically present in Colorado, but you must intend to both make Colorado your permanent home and to abandon your previous state of legal residence. In order to claim this subtraction, a taxpayer must include with his or her return: (1) a military form showing Colorado as his or her home of record, (2) evidence of acquiring residency in another state, and (3) evidence of reacquiring residency in Colorado during the tax year. Evidence of acquiring residency in another state and reacquiring residency in Colorado must come in one of the following forms: 1. voter registration; 2. records reflecting the purchase of residential property or an unimproved residential lot; 3. motor vehicle titling and registration; 4. notification to your prior state of legal residence of your intention to change your state of legal residence; 5. preparation of a new last will and testament reflecting your state of legal residence. If you qualify for this subtraction, enter the amount of compensation received for active duty military service on line 16 and submit all required evidence of residency with your return. Line 17 First-time Home Buyer Savings Account Interest Deduction You must complete the DR 0350 and submit with your return if you are claiming this deduction. You may only deduct the amount of taxable interest and/or earnings on the qualified account in the tax year claimed. This deduction is subject to recapture. Line 18 Other Subtractions from Federal Taxable Income Enter the sum of all other allowable subtractions. For more information about what to enter on this line, see the Income Tax – Subtractions page on Tax.Colorado.gov.

Do not include amounts that were earned outside Colorado, net operating losses, K-1 adjustments, military income, wage adjustments, repayments for which IRC section 1341 credits were claimed, or donations made to the Military Family Relief Fund on this line. Include a clear explanation of the subtraction being claimed on your return. Line 19 Subtractions Allowed Under HB21-1002 Under HB21-1002, taxpayers may claim a subtraction for tax years commencing in 2021 in relation to certain retroactive provisions of the CARES Act. For complete instructions on how to calculate this subtraction, please see the CARES Act guidance publication available at Tax.Colorado.gov/individual-income-tax-guidance-publications. In general, the allowable subtraction is an aggregate amount, calculated in multiple steps, based on the taxpayer’s Colorado taxable income for each of the preceding tax years which were affected by the CARES Act. First, the taxpayer must calculate, for each tax year beginning before March 27, 2020, the difference between their Colorado taxable income based on Colorado law and the amount the taxpayer’s Colorado taxable income would have been had certain provisions of the CARES Act applied to that tax year. The difference amounts calculated for each year are then aggregated and combined with the sum of addbacks for the business interest expense deduction, excess business losses, and net operating losses, pursuant to C.R.S. 39-22-104(3)(l),(m), and (n), for any prior tax year. The subtraction applies only after all other subtractions provided for in C.R.S. 39-22-104(4) and is limited to $300,000. Any amount of the allowable subtraction the taxpayer may not claim for the tax year commencing during 2021 may be carried forward to subsequent tax years. See the Guidance Publication for thorough instructions on how to calculate and claim this subtraction. Line 20 Subtotal Enter the sum of lines 1 through 19.

Page 14 Instructions for form DR 0104US–Consumer Use Tax Reporting Schedule Was Colorado sales or use tax paid on purchases of tangible personal property that is used, stored, or consumed within Colorado? YES: Some purchases will have sales or use tax included. Check your invoices and receipts to see if sales tax was paid. If sales tax was paid on all of your purchases, no consumer use tax is due. DO NOT FILL OUT THIS FORM. NO: Some sellers, either inside or outside of Colorado, may not collect sales or use tax from customers on purchases. Total the amount of your 2021 purchases where no tax was paid. State and special district (if applicable) consumer use tax must be paid on your purchases. Lines 1–2 State Consumer Use Tax Enter the total amount of 2021 purchases where no state sales tax or use tax was paid on line 1. Multiply line 1 by 0.029 (for the Colorado state sales tax rate of 2.9%). Round this number to the nearest whole dollar to calculate your Colorado consumer use tax liability. Enter this number on line 2. Lines 3–6 Special District Use Tax Use the table below to determine if you lived within a special district(s) in 2021. Report the total amount of 2021 purchases where no special district tax was paid on line 3. Then, enter the Special District Consumer Use (SDCU) code based on you lived in 2021 on line 4. If no special districts apply, enter 00 in the SDCU code field on line 4 and skip to line 6. Enter the special district use tax rate on line 5. Multiply line 3 by line 5. Round this number to the nearest whole dollar and enter your special district use tax liability on line 6. If no special districts apply, enter $0. Line 7 Enter the sum of lines 2 and 6. Transfer this amount to DR 0104 line 16. Submit this schedule with the DR 0104. Special District Name and Boundaries Use Tax Rate SDCU Code No Special District N/A 00 Regional Transportation District (RTD) Only The Denver metropolitan area including all of Boulder, Denver, and Jefferson Counties, northern Douglas County, the western areas of Adams and Arapahoe Counties, most of Broomfield County, and small part of southwest Weld County. 0.010 10 Scientific & Cultural Facilities District (CD) Only The Denver metropolitan area including all areas of Adams, Arapahoe, Boulder, Broomfield, Denver, and Jefferson Counties. All of Douglas county EXCEPT the city limits of Castle Rock and Larkspur. 0.001 20 Regional Transportation District (RTD) and Scientific & Cultural Facilities District (CD) Overlap between the RTD and CD districts (see individual descriptions above.) 0.011 12 Pikes Peak Rural Transportation Authority El Paso County EXCEPT within the municipal limits of Calhan, Fountain, Monument, Palmer Lake, or the Colorado Springs Commercial Aeronautical Zone. Note - Any areas annexed into these municipalities after 2004 are included in the PPRTA. 0.010 30 South Platte Valley Regional Transportation Authority Within the city limits of Sterling. 0.001 50 Roaring Fork Transportation Authority Within the city limits of Glenwood Springs or Carbondale. 0.010 61 Roaring Fork Transportation Authority Within the city limits of Basalt or New Castle. 0.008 62 Roaring Fork Transportation Authority Areas of unincorporated Eagle County in the El Jebel area and outside the city limits of Carbondale. 0.006 63 Roaring Fork Transportation Authority Aspen and Snowmass Village city limits, unincorporated Pitkin County. 0.004 64 Special District Rates and Boundaries Table Reference publication DR 1002 at Tax.Colorado.gov, your county assessor’s office, or district maps for additional information to determine whether you live within the boundaries of the above special districts. Most residents of the Denver metropolitan area are within the district boundaries of both the Regional Transportation District (RTD) and the Scientific & Cultural Facilities District (CD).

Page 15 Instructions for Select Credits from the DR 0104CR

Note There are two credits that are available for the preservation of historic properties and structures. Each credit has a different certification process and is subject to different limitations and qualification requirements. Line 20 Historic Property Preservation Credit The carry forward of prior year Historic Property Preservation credit (§39-22-514, C.R.S.) must be claimed on line 20 of the DR 0104CR. For more information on this credit, review FYI Income 1. Lines 34-36 Preservation of Historic Structures Credit The Preservation of Historic Structures credit (§39-22- 514.5, C.R.S.) must be claimed on lines 34 through 36 of the DR 0104CR. For more information on this credit, review resources available online from the Colorado Office of Economic Development or from History Colorado. Lines 2 through 5 To Calculate the Colorado Earned Income Tax Credit (EITC) for SSN Filers on DR 0104CR: Line 2 Enter the amount of earned income calculated for your federal return. In order to calculate the value of your Federal earned income tax credit, you must determine the amount of earned income. You may use the Earned Income Credit Worksheet (EIC Worksheet) and the Earned Income Credit (EIC) Table in the instruction booklet for Federal Form 1040, 1040SR, or 1040SP or use the EITC Assistant Tool online: IRS.gov/Credits-&-Deductions/Individuals/Earned-In- come-Tax-Credit/Use-the-EITC-Assistant. It is available in both English and Spanish. Line 3 The federal EITC you claimed Refer to the credit you entered on the Federal Form 1040.

• Enter the amount of line 27a from Federal Form 1040, 1040SR, or 1040SP on the Colorado Form DR 0104CR line 3. Table Instructions: If you have a qualifying child and you claimed the EITC on the Federal 1040, 1040SR, or 1040SP, you will need to identify that child or those children in this table. Enter each qualifying child’s last name, first name, year of birth and Social Security number. Only check the “Deceased” box for a qualifying child if the child was born and died in 2021 and was not assigned an SSN, you must submit a copy of the child’s birth certificate, death certificate, or hospital records showing a live birth with your return. Line 4 COEITC Multiply the amount you entered on line 3 by 0.1 to calculate your Colorado EITC. Line 5 If you are filing as a part-year resident ONLY Multiply the amount you entered on line 4 by the percentage on the DR 0104PN line 34. (If the percentage exceeds 100%, use 100%.) Enter the result on line 5. This is the portion of the Colorado EITC you are allowed. Line 1 Child Care Expenses Credit (DR 0347 and DR 0104CR Part I) Taxpayers who pay child care expenses during the year and whose Adjusted Gross Income is $60,000 or less may be able to claim a child care expenses credit. Use form DR 0347 to calculate this credit and submit it along with the form DR 0104CR. Line 6 Business Personal Property Credit for Individual Business Owners The income tax credit for business personal property taxes is limited to $18,000 of the actual value of your personal property that you paid tax on during 2021. This is different than real property, which is not eligible for this credit. If your actual value is less than $18,000, you can claim the total amount of the assessment you paid, and you must include the assessor’s statement(s) for which you are claiming the credit. To find your actual value, either look for it on your statement, or find your assessed value and divide it by 0.29. Actual Value = Assessed Value/0.29. If you own personal property whose actual value is above $18,000 for which you were assessed, you can only claim the assessment on the first $18,000 of the property in question. You will need to prorate your assessment with the following formula: 18,000 * assessment = allowable credit actual value For example, if your assessment was $2,000 for personal property tax paid in 2021, but your actual value was $25,000, you would be permitted to claim $1,440 (72% of the tax assessed or ($18,000/$25,000)*$2,000)).

Please include a copy of your property tax statement for property tax paid in 2021. Line 8 Expanded Colorado Earned Income Tax Credit for ITIN Filers If you could not claim a federal EITC only because you, your spouse, or your dependents have an Individual Taxpayer Iden- tification Number (ITIN) or a Social Security Number (SSN) that is not valid for employment, then you may be able to claim a Colorado Earned Income Tax Credit (COEITC). If you were able to claim a federal EITC, but you were not able to include some of your dependents only because they have an ITIN or SSN that is not valid for employment, then you may be able to claim a higher COEITC. To determine your eligibility, complete the eligibility checklist on form DR 0104TN. If you are eligible, complete form DR 0104TN to calculate the credit. Enter the amount of your COEITC on line 8 of form DR 0104CR. Review the instructions on form DR 0104TN for more information. You must submit the DR 0104TN with your return.

Page 16 Line 38 Rural & Frontier Health Care Preceptor Credit In order to claim this credit, the taxpayer must: • Receive certification that the preceptor satisfied all requirements to receive the credit from the institution for which the preceptor teaches or from the regional AHEC office with jurisdiction over the area in which the preceptorship took place. This certification must be completed on the DR 0366. • Send an electronic copy of the completed certification (DR 0366) to the Department by email to dor_preceptor@state.co.us. • If the preceptor receives notification from the Department that the taxpayer is entitled to claim the credit, file a Colorado income tax return and claim the credit on the return. You must submit the DR 0366 with your return. Line 39 Retrofitting a Residence to Increase a Residence’s Visitability Credit An income tax credit is available to help people with an illness, impairment or disability retrofit their residence for greater accessibility and independence. Dependents and spouses are also eligible and allows for up to a $5,000 credit per person in the family with a disability. To claim the credit, you must have been issued a tax credit certificate from the Colorado Department of Local Affairs/Division of Housing. For more information about the application process, visit cdola.colorado.gov

Please provide a copy of your tax credit certificate(s) from the Department of Local Affairs/ Division of Housing when claiming this credit. Line 40 Credit for Employer Contributions to Employee 529 Plan Complete the DR 0289 and transfer over the amounts of credit available and used to the DR 0104CR. You must submit the DR 0289 with your return. Line 41 Credit for Employer Paid Leave of Absence for Live Organ Donation An income tax credit is available for employers who incurred expenses during the tax year by paying an employee during his or her leave of absence period (not to exceed ten working days or the hourly equivalent of ten working days per employee) for live organ donation and for the cost of temporary replacement help, if any, during an employee’s leave of absence period. The amount of credit allowed is 35% of eligible expenses, as defined in statute.(§39-22-540, C.R.S.). You may not claim a tax credit related to a leave of absence period for an employee who you pay $80,000 or more in wages during the income tax year. Review the instructions on form DR 0375 for more information. You must submit the DR 0375 with your return.

Page 17 2021 Colorado Income Tax Table with tax rate of 4.5% To find your tax from the table below, read down the taxable income column to the line containing your Colorado taxable income from DR 0104 line 7. Then read across to the tax column and enter this amount on DR 0104 line 8. Part-year residents and nonresidents, enter tax on DR 0104PN line 35. TAXABLE INCOME TAX Over But not over 0 10 0 10 30 1 30 50 2 50 75 3 75 100 4 100 200 7 200 300 11 300 400 16 400 500 20 500 600 25 600 700 29 700 800 34 800 900 38 900 1,000 43 1,000 1,100 47 1,100 1,200 52 1,200 1,300 56 1,300 1,400 61 1,400 1,500 65 1,500 1,600 70 1,600 1,700 74 1,700 1,800 79 1,800 1,900 83 1,900 2,000 88 2,000 2,100 92 2,100 2,200 97 2,200 2,300 101 2,300 2,400 106 2,400 2,500 110 2,500 2,600 115 2,600 2,700 119 2,700 2,800 124 2,800 2,900 128 2,900 3,000 133 3,000 3,100 137 3,100 3,200 142 3,200 3,300 146 3,300 3,400 151 3,400 3,500 155 3,500 3,600 160 3,600 3,700 164 3,700 3,800 169 3,800 3,900 173 3,900 4,000 178 4,000 4,100 182 4,100 4,200 187 4,200 4,300 191 4,300 4,400 196 4,400 4,500 200 4,500 4,600 205 TAXABLE INCOME TAX Over But not over 4,600 4,700 209 4,700 4,800 214 4,800 4,900 218 4,900 5,000 223 5,000 5,100 227 5,100 5,200 232 5,200 5,300 236 5,300 5,400 241 5,400 5,500 245 5,500 5,600 250 5,600 5,700 254 5,700 5,800 259 5,800 5,900 263 5,900 6,000 268 6,000 6,100 272 6,100 6,200 277 6,200 6,300 281 6,300 6,400 286 6,400 6,500 290 6,500 6,600 295 6,600 6,700 299 6,700 6,800 304 6,800 6,900 308 6,900 7,000 313 7,000 7,100 317 7,100 7,200 322 7,200 7,300 326 7,300 7,400 331 7,400 7,500 335 7,500 7,600 340 7,600 7,700 344 7,700 7,800 349 7,800 7,900 353 7,900 8,000 358 8,000 8,100 362 8,100 8,200 367 8,200 8,300 371 8,300 8,400 376 8,400 8,500 380 8,500 8,600 385 8,600 8,700 389 8,700 8,800 394 8,800 8,900 398 8,900 9,000 403 9,000 9,100 407 9,100 9,200 412 9,200 9,300 416 9,300 9,400 421 9,400 9,500 425 9,500 9,600 430 TAXABLE INCOME TAX Over But not over 9,600 9,700 434 9,700 9,800 439 9,800 9,900 443 9,900 10,000 448 10,000 10,100 452 10,100 10,200 457 10,200 10,300 461 10,300 10,400 466 10,400 10,500 470 10,500 10,600 475 10,600 10,700 479 10,700 10,800 484 10,800 10,900 488 10,900 11,000 493 11,000 11,100 497 11,100 11,200 502 11,200 11,300 506 11,300 11,400 511 11,400 11,500 515 11,500 11,600 520 11,600 11,700 524 11,700 11,800 529 11,800 11,900 533 11,900 12,000 538 12,000 12,100 542 12,100 12,200 547 12,200 12,300 551 12,300 12,400 556 12,400 12,500 560 12,500 12,600 565 12,600 12,700 569 12,700 12,800 574 12,800 12,900 578 12,900 13,000 583 13,000 13,100 587 13,100 13,200 592 13,200 13,300 596 13,300 13,400 601 13,400 13,500 605 13,500 13,600 610 13,600 13,700 614 13,700 13,800 619 13,800 13,900 623 13,900 14,000 628 14,000 14,100 632 14,100 14,200 637 14,200 14,300 641 14,300 14,400 646 14,400 14,500 650 14,500 14,600 655 14,600 14,700 659 14,700 14,800 664 14,800 14,900 668 14,900 15,000 673 15,000 15,100 677 TAXABLE INCOME TAX Over But not over 15,100 15,200 682 15,200 15,300 686 15,300 15,400 691 15,400 15,500 695 15,500 15,600 700 15,600 15,700 704 15,700 15,800 709 15,800 15,900 713 15,900 16,000 718 16,000 16,100 722 16,100 16,200 727 16,200 16,300 731 16,300 16,400 736 16,400 16,500 740 16,500 16,600 745 16,600 16,700 749 16,700 16,800 754 16,800 16,900 758 16,900 17,000 763 17,000 17,100 767 17,100 17,200 772 17,200 17,300 776 17,300 17,400 781 17,400 17,500 785 17,500 17,600 790 17,600 17,700 794 17,700 17,800 799 17,800 17,900 803 17,900 18,000 808 18,000 18,100 812 18,100 18,200 817 18,200 18,300 821 18,300 18,400 826 18,400 18,500 830 18,500 18,600 835 18,600 18,700 839 18,700 18,800 844 18,800 18,900 848 18,900 19,000 853 19,000 19,100 857 19,100 19,200 862 19,200 19,300 866 19,300 19,400 871 19,400 19,500 875 19,500 19,600 880 19,600 19,700 884 19,700 19,800 889 19,800 19,900 893 19,900 20,000 898 20,000 20,100 902 20,100 20,200 907 20,200 20,300 911 20,300 20,400 916 20,400 20,500 920 20,500 20,600 925 TAXABLE INCOME TAX Over But not over 20,600 20,700 929 20,700 20,800 934 20,800 20,900 938 20,900 21,000 943 21,000 21,100 947 21,100 21,200 952 21,200 21,300 956 21,300 21,400 961 21,400 21,500 965 21,500 21,600 970 21,600 21,700 974 21,700 21,800 979 21,800 21,900 983 21,900 22,000 988 22,000 22,100 992 22,100 22,200 997 22,200 22,300 1,001 22,300 22,400 1,006 22,400 22,500 1,010 22,500 22,600 1,015 22,600 22,700 1,019 22,700 22,800 1,024 22,800 22,900 1,028 22,900 23,000 1,033 23,000 23,100 1,037 23,100 23,200 1,042 23,200 23,300 1,046 23,300 23,400 1,051 23,400 23,500 1,055 23,500 23,600 1,060 23,600 23,700 1,064 23,700 23,800 1,069 23,800 23,900 1,073 23,900 24,000 1,078 24,000 24,100 1,082 24,100 24,200 1,087 24,200 24,300 1,091 24,300 24,400 1,096 24,400 24,500 1,100 24,500 24,600 1,105 24,600 24,700 1,109 24,700 24,800 1,114 24,800 24,900 1,118 24,900 25,000 1,123 25,000 25,100 1,127 25,100 25,200 1,132 25,200 25,300 1,136 25,300 25,400 1,141 25,400 25,500 1,145 25,500 25,600 1,150 25,600 25,700 1,154 25,700 25,800 1,159 25,800 25,900 1,163 25,900 26,000 1,168 26,000 26,100 1,172

Page 18 Worksheet for taxable incomes over $50,000 Colorado Taxable Income from Form 104 line 7 $ .00 Multiply by 4.5% X .045 Colorado Tax $ .00 Colorado Income Tax Table TAXABLE INCOME TAX Over But not over 26,100 26,200 1,177 26,200 26,300 1,181 26,300 26,400 1,186 26,400 26,500 1,190 26,500 26,600 1,195 26,600 26,700 1,199 26,700 26,800 1,204 26,800 26,900 1,208 26,900 27,000 1,213 27,000 27,100 1,217 27,100 27,200 1,222 27,200 27,300 1,226 27,300 27,400 1,231 27,400 27,500 1,235 27,500 27,600 1,240 27,600 27,700 1,244 27,700 27,800 1,249 27,800 27,900 1,253 27,900 28,000 1,258 28,000 28,100 1,262 28,100 28,200 1,267 28,200 28,300 1,271 28,300 28,400 1,276 28,400 28,500 1,280 28,500 28,600 1,285 28,600 28,700 1,289 28,700 28,800 1,294 28,800 28,900 1,298 28,900 29,000 1,303 29,000 29,100 1,307 29,100 29,200 1,312 29,200 29,300 1,316 29,300 29,400 1,321 29,400 29,500 1,325 29,500 29,600 1,330 29,600 29,700 1,334 29,700 29,800 1,339 29,800 29,900 1,343 29,900 30,000 1,348 30,000 30,100 1,352 30,100 30,200 1,357 30,200 30,300 1,361 30,300 30,400 1,366 30,400 30,500 1,370 30,500 30,600 1,375 30,600 30,700 1,379 30,700 30,800 1,384 30,800 30,900 1,388 30,900 31,000 1,393 31,000 31,100 1,397 31,100 31,200 1,402 31,200 31,300 1,406 31,300 31,400 1,411 31,400 31,500 1,415 31,500 31,600 1,420 TAXABLE INCOME TAX Over But not over 31,600 31,700 1,424 31,700 31,800 1,429 31,800 31,900 1,433 31,900 32,000 1,438 32,000 32,100 1,442 32,100 32,200 1,447 32,200 32,300 1,451 32,300 32,400 1,456 32,400 32,500 1,460 32,500 32,600 1,465 32,600 32,700 1,469 32,700 32,800 1,474 32,800 32,900 1,478 32,900 33,000 1,483 33,000 33,100 1,487 33,100 33,200 1,492 33,200 33,300 1,496 33,300 33,400 1,501 33,400 33,500 1,505 33,500 33,600 1,510 33,600 33,700 1,514 33,700 33,800 1,519 33,800 33,900 1,523 33,900 34,000 1,528 34,000 34,100 1,532 34,100 34,200 1,537 34,200 34,300 1,541 34,300 34,400 1,546 34,400 34,500 1,550 34,500 34,600 1,555 34,600 34,700 1,559 34,700 34,800 1,564 34,800 34,900 1,568 34,900 35,000 1,573 35,000 35,100 1,577 35,100 35,200 1,582 35,200 35,300 1,586 35,300 35,400 1,591 35,400 35,500 1,595 35,500 35,600 1,600 35,600 35,700 1,604 35,700 35,800 1,609 35,800 35,900 1,613 35,900 36,000 1,618 36,000 36,100 1,622 36,100 36,200 1,627 36,200 36,300 1,631 36,300 36,400 1,636 36,400 36,500 1,640 36,500 36,600 1,645 36,600 36,700 1,649 36,700 36,800 1,654 36,800 36,900 1,658 36,900 37,000 1,663 37,000 37,100 1,667 TAXABLE INCOME TAX Over But not over 37,100 37,200 1,672 37,200 37,300 1,676 37,300 37,400 1,681 37,400 37,500 1,685 37,500 37,600 1,690 37,600 37,700 1,694 37,700 37,800 1,699 37,800 37,900 1,703 37,900 38,000 1,708 38,000 38,100 1,712 38,100 38,200 1,717 38,200 38,300 1,721 38,300 38,400 1,726 38,400 38,500 1,730 38,500 38,600 1,735 38,600 38,700 1,739 38,700 38,800 1,744 38,800 38,900 1,748 38,900 39,000 1,753 39,000 39,100 1,757 39,100 39,200 1,762 39,200 39,300 1,766 39,300 39,400 1,771 39,400 39,500 1,775 39,500 39,600 1,780 39,600 39,700 1,784 39,700 39,800 1,789 39,800 39,900 1,793 39,900 40,000 1,798 40,000 40,100 1,802 40,100 40,200 1,807 40,200 40,300 1,811 40,300 40,400 1,816 40,400 40,500 1,820 40,500 40,600 1,825 40,600 40,700 1,829 40,700 40,800 1,834 40,800 40,900 1,838 40,900 41,000 1,843 41,000 41,100 1,847 41,100 41,200 1,852 41,200 41,300 1,856 41,300 41,400 1,861 41,400 41,500 1,865 41,500 41,600 1,870 41,600 41,700 1,874 41,700 41,800 1,879 41,800 41,900 1,883 41,900 42,000 1,888 42,000 42,100 1,892 42,100 42,200 1,897 42,200 42,300 1,901 42,300 42,400 1,906 42,400 42,500 1,910 42,500 42,600 1,915 TAXABLE INCOME TAX Over But not over 42,600 42,700 1,919 42,700 42,800 1,924 42,800 42,900 1,928 42,900 43,000 1,933 43,000 43,100 1,937 43,100 43,200 1,942 43,200 43,300 1,946 43,300 43,400 1,951 43,400 43,500 1,955 43,500 43,600 1,960 43,600 43,700 1,964 43,700 43,800 1,969 43,800 43,900 1,973 43,900 44,000 1,978 44,000 44,100 1,982 44,100 44,200 1,987 44,200 44,300 1,991 44,300 44,400 1,996 44,400 44,500 2,000 44,500 44,600 2,005 44,600 44,700 2,009 44,700 44,800 2,014 44,800 44,900 2,018 44,900 45,000 2,023 45,000 45,100 2,027 45,100 45,200 2,032 45,200 45,300 2,036 45,300 45,400 2,041 45,400 45,500 2,045 45,500 45,600 2,050 45,600 45,700 2,054 45,700 45,800 2,059 45,800 45,900 2,063 45,900 46,000 2,068 46,000 46,100 2,072 46,100 46,200 2,077 46,200 46,300 2,081 46,300 46,400 2,086 46,400 46,500 2,090 46,500 46,600 2,095 TAXABLE INCOME TAX Over But not over 46,600 46,700 2,099 46,700 46,800 2,104 46,800 46,900 2,108 46,900 47,000 2,113 47,000 47,100 2,117 47,100 47,200 2,122 47,200 47,300 2,126 47,300 47,400 2,131 47,400 47,500 2,135 47,500 47,600 2,140 47,600 47,700 2,144 47,700 47,800 2,149 47,800 47,900 2,153 47,900 48,000 2,158 48,000 48,100 2,162 48,100 48,200 2,167 48,200 48,300 2,171 48,300 48,400 2,176 48,400 48,500 2,180 48,500 48,600 2,185 48,600 48,700 2,189 48,700 48,800 2,194 48,800 48,900 2,198 48,900 49,000 2,203 49,000 49,100 2,207 49,100 49,200 2,212 49,200 49,300 2,216 49,300 49,400 2,221 49,400 49,500 2,225 49,500 49,600 2,230 49,600 49,700 2,234 49,700 49,800 2,239 49,800 49,900 2,243 49,900 50,000 2,248

*210104==19999* DR 0104 (12/07/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 4 2021 Colorado Individual Income Tax Return Full-Year Part-Year or Nonresident (or resident, part-year, non-resident combination) *Must include DR 0104PN Mark if Abroad on due date – see instructions Your Last Name Your First Name Middle Initial Date of Birth (MM/DD/YYYY) SSN or ITIN Deceased If checked and claiming a refund, you must include the DR 0102 and death certificate with your return. Enter the following information from your current driver license or state identification card. State of Issue Last 4 characters of ID number Date of Issuance If Joint, Spouse’s Last Name Spouse’s First Name Middle Initial Spouse’s Date of Birth (MM/DD/YYYY) Spouse’s SSN or ITIN Deceased If checked and claiming a refund, you must include the DR 0102 and death certificate with your return. Enter the following information from your spouse’s current driver license or state identification card. State of Issue Last 4 characters of ID number Date of Issuance Mailing Address Phone Number City State ZIP Code Foreign Country (if applicable) To see if you or members of your household qualify for free or reduced-cost health coverage, check this box if: • You are a Colorado resident and at least one person in your household does not have health coverage AND • You give permission for the Colorado Department of Revenue to share the information on Form DR 0104EE with Connect for Health Colorado (the Colorado Health Benefit Exchange) and the Department of Health Care Policy & Financing. Round To The Nearest Dollar 1. Enter Federal Taxable Income from your federal income tax form: 1040, 1040 SR, or 1040 SP line 15. 1 0 0 Include W-2s and 1099s with CO withholding. Additions to Federal Taxable Income 2. State Addback, enter the state income tax deduction from your federal form 1040, 1040 SR, or 1040 SP schedule A, line 5a (see instructions) 2 0 0 3. Qualified Business Income Deduction Addback (see instructions) 3 0 0 (0013)

4. Other Additions, explain (see instructions) 4 0 0 Explain: 5. Subtotal, sum of lines 1 through 4 5 0 0 Colorado Subtractions 6. Subtractions from the DR 0104AD Schedule, line 20, you must submit the DR 0104AD schedule with your return. 6 0 0 7. Colorado Taxable Income, subtract line 6 from line 5 7 0 0 Tax, Prepayments and Credits: see 104 Book for full-year tax table and part-year DR 0104PN Schedule 8. Colorado Tax from tax table or the DR 0104PN line 36, you must submit the DR 0104PN with your return if applicable. 8 0 0 9. Alternative Minimum Tax from the DR 0104AMT line 8, you must submit the DR 0104AMT with your return. 9 0 0 10. Recapture of prior year credits 10 0 0 11. Subtotal, sum of lines 8 through 10 11 0 0 12. Nonrefundable Credits from the DR 0104CR line 43, the sum of lines 12, 13, and 14 cannot exceed line 11, you must submit the DR 0104CR with your return. 12 0 0 13. Total Nonrefundable Enterprise Zone credits used – as calculated, or from the DR 1366 line 84, the sum of lines 12, 13, and 14 cannot exceed line 11, you must submit the DR 1366 with your return. 13 0 0 14. Strategic Capital Tax Credit from DR 1330, the sum of lines 12, 13, and 14 cannot exceed line 11, you must submit the DR 1330 with your return. 14 0 0 15. Net Income Tax, sum of lines 12, 13, and 14. Subtract that sum from line 11. 15 0 0 16. Use Tax reported on the DR 0104US schedule line 7, you must submit the DR 0104US with your return. 16 0 0 17. Net Colorado Tax, sum of lines 15 and 16 17 0 0 18. CO Income Tax Withheld from W-2s and 1099s, you must submit the W-2s and/or 1099s claiming Colorado withholding with your return. 18 0 0 19. Prior-year Estimated Tax Carryforward 19 0 0 20. Estimated Tax Payments, enter the sum of the quarterly payments remitted for this tax year 20 0 0 21. Extension Payment remitted with the DR 0158-I 21 0 0 22. Other Prepayments: DR 0104BEP DR 0108 DR 1079 22 0 0 23. Gross Conservation Easement Credit from the DR 1305G line 33, you must submit the DR 1305G with your return. 23 0 0 24. Innovative Motor Vehicle Credit from the DR 0617, you must submit each DR 0617 with your return. 24 0 0 Name SSN or ITIN DR 0104 (12/07/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 4 *210104==29999*

25. Refundable Credits from the DR 0104CR line 9, you must submit the DR 0104CR with your return. 25 0 0 26. Subtotal, sum of lines 18 through 25 26 0 0 Modified AGI for TABOR Lines 28 through 30 are only used to calculate your TABOR Credit, they do not affect your Colorado tax liability. 27. Federal Adjusted Gross Income from your federal income tax form: 1040 line 11, 1040 SR line 11, or 1040 SP line 11 27 0 0 28. Nontaxable Social Security Income 28 0 0 29. Nontaxable Lump-sum Distribution from pension and profit sharing plans. 29 0 0 30. Nontaxable interest income from state and local bonds 30 0 0 31. Sum of lines 27 through 30: Modified AGI for TABOR 31 0 0 Modified AGI Tiers for State Sales Tax Refund If line 31 is: $44,000 or less $44,001 – $88,000 $88,001 – $139,000 $139,001 – $193,000 $193,001 – $246,000 $246,001 – or more Single Filers Enter $37 $49 $56 $68 $74 $117 Joint Filers Enter $74 $98 $112 $136 $148 $234 32. State Sales Tax Refund: For full-year Colorado residents, born before 2003, or full-year Colorado residents who are under the age of eighteen but are required to file a return. Use the amount on line 31 and reference the table above. See instructions if you are filing an extension. 32 0 0 33. Sum of lines 26 and 32 33 0 0 34. Overpayment, if line 33 is greater than line 17 then subtract line 17 from line 33 34 0 0 35. Estimated Tax Credit Carryforward to 2022 first quarter, if any. 35 0 0 If you have an overpayment on line 36 below and would like to donate all or a portion of your overpayment to a qualified Colorado charity, include Form DR 0104CH to contribute. 36. Refund, subtract line 35 from line 34 (see instructions) 36 0 0 Direct Deposit Routing Number Type: Checking Savings CollegeInvest 529 Account Number For questions regarding CollegeInvest direct deposit or to open an account, visit CollegeInvest.org or call 800-448-2424. DR 0104 (12/07/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 3 of 4 *210104==39999* Name SSN or ITIN

*210104==49999* 37. Net Tax Due, subtract line 33 from line 17 37 0 0 38. Delinquent Payment Penalty (see instructions) 38 0 0 39. Delinquent Payment Interest (see instructions) 39 0 0 40. Estimated Tax Penalty, you must submit the DR 0204 with your return. (see instructions) 40 0 0 41. Amount You Owe, sum of lines 37 through 40 41 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. Third Party Designee Do you want to allow another person to discuss this return and any related information with the Colorado Department of Revenue? See the instructions. No Yes. Complete the following: Designee’s Name Phone Number Sign Below Under penalties of perjury, I declare that to the best of my knowledge and belief, this return is true, correct and complete. Your Signature Date (MM/DD/YY) Spouse’s Signature. If joint return, BOTH must sign. Date (MM/DD/YY) Paid Preparer’s Name Paid Preparer’s Phone Paid Preparer’s Address City State ZIP Code Name SSN or ITIN DR 0104 (12/07/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 4 of 4 If you are filing this return with a check or payment, please mail the return to: COLORADO DEPARTMENT OF REVENUE Denver, CO 80261-0006 If you are filing this return without a check or payment, please mail the return to: COLORADO DEPARTMENT OF REVENUE Denver, CO 80261-0005 These addresses and zip codes are exclusive to the Colorado Department of Revenue, so a street address is not required. File and pay at: Colorado.gov/RevenueOnline

*210104EE19999* DR 0104EE (06/03/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 2 Colorado Easy Enrollment Information Form Colorado taxpayers can now share certain information from their tax return with the Colorado Health Benefit Exchange (Connect for Health Colorado) and the Colorado Department of Health Care Policy & Financing to find out if they qualify for free or reduced-cost health coverage (Colorado Law: 39-21-113(25) C.R.S). By submitting this form (DR 0104EE) and checking the corresponding checkbox with my income tax return (form DR 0104), I give permission for the Colorado Department of Revenue to share the information included on this form with the Colorado Health Benefit Exchange (Connect for Health Colorado) and the Department of Health Care Policy & Financing Note: If you agree to share this information, please complete (or verify) this form to the best of your ability and include it with your tax return. If filing by paper, ensure that it is mailed with your return. If filing electronically through your tax preparer or a using a software program, this form may be completed using the software. If you do not agree to share this information, please do not complete this form and do not include it with your return. Section A: Household Contact Information Last Name First Name Middle Initial Phone Number Email Address Mailing Address (Line 1) Mailing Address (Line 2) City State ZIP Code

Section B: Household Member and Income Information Complete this section with information for all members of your tax household. For purposes of obtaining health coverage, your tax household typically consists of yourself, your spouse, and any person that you claim as a tax dependent on your federal income tax return. For more information about who may be claimed as a tax dependent on your federal income tax return and would be considered a part of you tax household, review IRS Publication 501. 1. Enter your tax household size here. Include yourself, your spouse, and all individuals that you claim as a dependent on your federal income tax return (i.e. a household with spouses filing jointly and one tax dependent child = household size of 3; enter “3” in this field). 1 2. Enter your adjusted gross income from line 11 on your federal form 1040, 1040-SR, 1040(SP), or 1040-NR. 2 0 0 3. Enter information about yourself, your spouse, and all individuals that you claim as a dependent on your federal income tax return in the table below. Last Name First Name Middle Initial Date of Birth SSN or ITIN (optional) *210104EE29999* DR 0104EE (06/03/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 2

*210104CH19999* DR 0104CH (11/08/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 2 2021 Voluntary Contributions Schedule If you are making a voluntary contribution and filing by paper, you must submit this schedule with your return. Instructions: Name SSN or ITIN If line 36 on the DR 0104 is NOT greater than zero, STOP. You cannot complete this schedule. 1. Colorado Nongame Conservation and Wildlife Restoration Cash Fund 1 0 0 2. Colorado Domestic Abuse Program Fund 2 0 0 3. Homeless Prevention Activities Program Fund 3 0 0 4. Western Slope Military Veterans Cemetery Fund 4 0 0 5. Pet Overpopulation Fund 5 0 0 6. Military Family Relief Fund 6 0 0 7. American Red Cross Colorado Disaster Response, Readiness, and Preparedness Fund 7 0 0 8. Habitat for Humanity of Colorado Fund 8 0 0 9. Special Olympics of Colorado Fund 9 0 0 10. Colorado Healthy Rivers Fund 10 0 0 11. Alzheimer’s Association Fund 11 0 0 12. Colorado Cancer Fund 12 0 0 13. Make-A-Wish Foundation of Colorado Fund 13 0 0 Use this form to make voluntary contributions using your refund to selected Colorado charities. If you would like to donate all or a portion of your refund to one of the organizations available to receive voluntary contributions, enter the desired amount here. See the back of the 104 Book for more information about each of these charitable organizations. You must submit this form along with the DR 0104 to ensure that your selected organizations receive the donations you have designated.

Name SSN or ITIN DR 0104CH (11/08/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 2 *210104CH29999* 14. Unwanted Horse Fund 14 0 0 15. Urban Peak Housing and Support Services for Youth Experiencing Homelessness Fund 15 0 0 16. This line is reserved for future use. 16 17. Donate to a Colorado Nonprofit Fund 17 0 0 Enter the 11-digit Secretary of State Registration Number for the Registered Charitable Organization Enter the Name of the Registered Charitable Organization 18. Total of lines 1 through 17. This cannot exceed the amount on line 36 on the DR 0104. 18 0 0 19. Subtract line 18 from the amount on line 36 on the DR 0104. This is the amount of your net refund. (See box below) 19 0 0 DO NOT CUT – Return Full Page This form is used to request a donation to a qualified charity or charities from your tax refund. The amount of your donation(s) requested on this form may be decreased if a reduction is made to your refund after processing of your return. Donation(s) will also be decreased if you owe back taxes or if you owe a balance to another Colorado government agency or the IRS. Amounts cannot be changed once your return has been submitted. Donation requests cannot be changed with an amended return.

*210104AD19999* DR 0104AD (10/22/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 2 2021 DR 0104AD – Subtractions from Income Schedule If claiming a subtraction and filing by paper, you must submit this schedule with your return. Use this schedule to report any subtractions from your Federal Taxable Income. These subtractions will change your Colorado Taxable Income from the amount of Federal Taxable Income. See instructions in the income tax booklet for additional guidance on completing this schedule. Do not enter negative amounts. You must submit this form along with the DR 0104 if claiming any subtractions. Name SSN or ITIN Subtractions from Federal Taxable Income 1. State Income Tax Refund from federal income tax form 1040, 1040 SR, or 1040 SP, Schedule 1 line 1. 1 0 0 2. U.S. Government Interest 2 0 0 3. Primary Taxpayer Pension, Annuity, IRA, Social Security, or Disability Income (see instructions) Deceased SSN or ITIN 3 0 0 4. Spouse Pension, Annuity, IRA, Social Security, or Disability Income (see instructions) Deceased SSN or ITIN 4 0 0 5. Primary Taxpayer Military Retirement Benefits (under age 55), you must submit copies of all 1099R statements with your return. (see instructions) 5 0 0 6. Spouse Military Retirement Benefits (under age 55), you must submit copies of all 1099R statements with your return. (see instructions) 6 0 0 7. Colorado Capital Gain Subtraction 7 0 0 8. CollegeInvest Contribution: (see instructions) Owner’s SSN or ITIN 8 0 0 Total Contribution Owner’s Name 9. Qualifying Charitable Contribution Total Contribution 9 $ 0 0 10. Qualified Reservation Income 10 0 0 11. PERA/DPSRS Subtraction, for PERA contributions made in 1984–1986 or DPSRS contributions made in 1986 11 0 0

*210104AD29999* DR 0104AD (10/22/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 2 Name SSN or ITIN 12. Railroad Benefit Subtraction 12 0 0 13. Wildfire Mitigation Measures Subtraction 13 0 0 14. Colorado Marijuana Business Deduction

14 0 0 15. Non-Resident Disaster Relief Worker Subtraction

15 0 0 Natural Disaster: Enter the executive order number(s) from the Colorado governor’s office that declared the state disaster emergency “D YYYY-###” (see instructions) 16. Reacquisition of Colorado Residency During Active Duty Military Service Subtraction 16 0 0 17. First Time Home Buyer Savings Account Interest Deduction, you must submit form DR 0350(s) with your return 17 0 0 18. Other Subtractions, explain below 18 0 0 Explain 19. Subtractions Allowed Under HB21-1002 (see instructions) 19 0 0 20. Subtotal, sum of lines 1 through 19, transfer the amount to line 6 on the DR 0104 20 0 0

*210900==19999* DR 0900 (06/03/21) COLORADO DEPARTMENT OF REVENUE Denver CO 80261-0008 Tax.Colorado.gov Page 1 of 1 (0011) 2021 Individual Income Tax Payment Form (Calendar year — Due April 15, 2022) Caution! This form MUST accompany your payment if you filed electronically and wish to pay by check. If you paid electronically or do not owe a payment do not file this form. DR 0900 (06/03/21) Return the DR 0900 with check or money order payable to the “Colorado Department of Revenue”. Mail payments to Colorado Department of Revenue, Denver, Colorado 80261-0008. These addresses and zip codes are exclusive to the Colorado Department of Revenue, so a street address is not required. Write your Social Security number or ITIN and “2021 DR 0104” on your check or money order. Do not send cash. Enclose, but do not staple or attach, your payment with this form. SSN or ITIN Your Last Name First Name Middle Initial Spouse’s SSN or ITIN Spouse’s Last Name (if joint) Spouse’s First Name Middle Initial Address City State ZIP Code

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. Amount of Payment $ DO NOT CUT – Return Full Page DO NOT CUT – Return Full Page The Department strongly recommends that you file using Revenue Online (Colorado.gov/RevenueOnline) or another electronic filing method and remit your payment electronically or by EFT. Information on EFT can be found at Tax.Colorado.gov/electronic-funds-transfer To pay by mail, make the check or money order payable to the “Colorado Department of Revenue.” Be sure to round your payment to the nearest dollar. Clearly write your Social Security number or ITIN and “2021 DR 0104” on the memo line. Be sure to keep a copy of the money order or note the check number with your tax records. Complete the form below. The amount on the check and the amount entered on the payment form must be the same. This will help maintain accuracy in your tax account. DO NOT submit the DR 0104 if you have already filed electronically. IF NO PAYMENT IS DUE, DO NOT FILE THIS FORM

*210158-I19999* DR 0158-I (06/03/21) COLORADO DEPARTMENT OF REVENUE Denver CO 80261-0008 Tax.Colorado.gov Page 1 of 1 (0019) 2021 Extension Payment for Colorado Individual Income Tax (calendar year — Due April 15, 2022) Filing extensions are granted automatically, only return this form if you need to make an additional payment of tax. DR 0158-I (06/03/21) Tax Payment Worksheet – Photocopy for your records before returning 1. Income tax you expect to owe 2. Tax payments and credits: a. Colorado income tax withheld b. Colorado estimated income tax payments c. Other payments and credits d. Total tax payments and credits – Add lines 2a through 2c 3. Tax due–Subtract line 2d from line 1. Enter the result here and on the form below Return the DR 0158-I with check or money order payable to the “Colorado Department of Revenue”. Mail payments to Colorado Department of Revenue, Denver, Colorado 80261-0008. These addresses and zip codes are exclusive to the Colorado Department of Revenue, so a street address is not required. Write your Social Security number or ITIN and “2021 DR 0158-I” on your check or money order. Do not send cash. Enclose, but do not staple or attach, your payment with this form. File only if you are making a payment by check or money order. SSN or ITIN Your Last Name First Name Middle Initial Spouse’s SSN or ITIN Spouse’s Last Name (if joint) Spouse’s First Name Middle Initial Address City State ZIP Code 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. Amount of Payment $ DO NOT CUT – Return Full Page IF NO PAYMENT IS DUE, DO NOT FILE THIS FORM Automatic Filing Extension Colorado offers an automatic six-month extension to file your income tax return if you cannot submit your return by the April 15 due date. This means that you can file your return by October 15. While there is an extension to file, there is not an extension to the payment due date. Penalty and interest are assessed if certain payment criteria are not met. Please review FYI General 11 for more information on penalty and interest. If you must wait until October 15 to file your return, use the following worksheet to calculate whether you need to remit a payment on April 15. If the due date falls on a weekend or federal holiday, payment will be due the next business day. Persons Traveling or Residing Abroad If you are traveling or residing outside the United States on April 15, the deadline for filing your return is June 15. The extension due date for filing remains October 15. If the due date falls on a weekend or federal holiday, payment will be due the next business day. Pay Online Visit Colorado.gov/RevenueOnline to pay online. Online payments reduce errors and provide instant payment confirmation. Revenue Online also allows users to submit various forms and to monitor their tax account. Electronic Funds Transfer (EFT) Debit and Credit options are free services offered by the department. EFT services require pre-registration before payments can be made. Visit Tax.Colorado.gov/electronic-funds-transfer for more information. The DR 0158-I is not required to be sent if an online payment is made. Please be advised that a nominal processing fee may apply to e-check or credit card payments.

*210104PN19999* Form 104PN Part-Year Resident/Nonresident Tax Calculation Schedule 2021 Taxpayer’s Name SSN or ITIN Use this form if you and/or your spouse were a resident of another state for all or part of 2021. This form apportions your gross income so that Colorado tax is calculated for only your Colorado income. Complete this form after you have filled out lines 1 through 7 of the DR 0104. If you filed federal form 1040NR, see the instructions. Beginning (MM/YY) Ending (MM/YY) 1. Taxpayer is (mark one): Full-Year Nonresident Part-Year Resident from Full-Year Resident Nonresident 305-day rule Military Beginning (MM/YY) Ending (MM/YY) 2. Spouse is (mark one): Full-Year Nonresident Part-Year Resident from Full-Year Resident Nonresident 305-day rule Military 3. Mark the federal form you filed: 1040 1040 NR 1040 SR Other Federal Information Colorado Information 4. Enter all income from form 1040, 1040 SR, or 1040 SP line 1. 4 00 5. 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. 5 00 6. Enter the sum of all interest/dividend income from form 1040, 1040 SR or 1040 SP lines 2b and 3b. 6 00 7. Enter income from line 6 that was earned while you were a resident of Colorado or derived from the ownership of real or tangible personal property located in Colorado. 7 00 8. Enter all income from form 1040, 1040 SR or 1040 SP, Schedule 1, line 7. 8 00 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 Colorado resident. 9 00 10. Enter all income from line 7 of form 1040, 1040 SR, or 1040 SP and line 4 of Schedule 1 of form 1040, 1040 SR or 1040 SP. 10 00 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 00 DR 0104PN (11/15/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 3

Federal Information Colorado Information 12. Enter the sum of all income from form 1040, 1040 SR, or 1040 SP lines 4b, 5b and 6b. 12 00 13. Enter income from line 12 that was received during that part of the year you were a Colorado resident. 13 00 14. Enter the sum of all business and farm income from form 1040, 1040 SR, or 1040 SP, Schedule 1, lines 3 and 6. 14 00 15. Enter income from line 14 that was earned during that part of the year you were a Colorado resident and/or was earned from Colorado sources. 15 00 16. Enter all Schedule E income from form 1040, 1040 SR, or 1040 SP, Schedule 1, line 5. 16 00 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 the part of the year you were a Colorado resident; and/or partnership/S corporation/fiduciary income that is taxable to Colorado during the tax year. 17 00 18. Enter the sum of all other income from form 1040, 1040 SR, or 1040 SP, Schedule 1, lines 1, 2a and 9. 18 00 List Type 19. Enter income from line 18 that was earned during that part of the year you were a Colorado resident and/or was derived from Colorado sources. 19 00 List Type 20. Total Income. Enter amount from form 1040, 1040 SR, or 1040 SP, line 9. 20 00 21. Total Colorado Income. Enter the total from the Colorado column, lines 5, 7, 9, 11, 13, 15, 17 and 19. 21 00 22. Enter all federal adjustments from form 1040, 1040 SR, or 1040 SP, line 10. 22 00 List Type 23. Enter adjustments from line 22 as follows 23 00 List Type • Educator expenses, IRA deduction, business expenses of reservists, performing artists and fee-basis government officials, health savings account deduction, self-employment tax, self-employed health insurance deduction, SEP and SIMPLE deductions are allowed in the ratio of Colorado wages and/or self-employment income to total wages and/or self-employment income. • Student loan interest deduction, alimony, and tuition and fees deduction are allowed in the Colorado to federal total income ratio (line 21 / line 20). • Penalty paid on early withdrawals made while a Colorado resident. • Moving expenses for members of the Armed Forces. For treatment of other adjustments reported on federal form 1040, 1040 SR, or 1040 SP, line 10, see the Colorado Individual Income Tax Guide and/or the Income Tax Topics: Part-Year Residents & Nonresidents. DR 0104PN (11/15/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 3 *210104PN29999* Name SSN or ITIN

DR 0104PN (11/15/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 3 of 3 *210104PN39999* Federal Information Colorado Information 24. Adjusted Gross Income. Enter amount from form 1040, 1040 SP, or 1040 SR line 11. 24 00 25. Colorado Adjusted Gross Income. Subtract the amount on line 23 of Form 104PN from the amount on line 21 of Form 104PN. 25 00 26. Additions to Adjusted Gross Income. Enter the sum of lines 3 and 4 of Colorado Form 104 excluding any charitable contribution adjustments. 26 00 27. Additions to Colorado Adjusted Gross Income. Enter any amount from line 26 that is from non-Colorado state or local bond interest earned while a Colorado resident.* 27 00 28. Total of lines 24 and 26 28 00 29. Total of lines 25 and 27 29 00 30. Subtractions from Adjusted Gross Income. Enter the amount from line 6 of Colorado Form 104 excluding any qualifying charitable contributions. 30 00 31. Subtractions from Colorado Adjusted Gross Income. Enter any amount from line 30 as follows: 31 00 • The state income tax refund subtraction to the extent included on line 19 above • The federal interest subtraction to the extent included on line 7 above • The pension/annuity subtraction and the PERA or DPS retirement subtraction to the extent included on line 13 above • The Colorado capital gain subtraction to the extent included on line 20 above For treatment of other subtractions, see the Individual Income Tax Guide and/or the Income Tax Topics: Part-Year Residents & Nonresidents. 32. Modified Adjusted Gross Income. Subtract line 30 from line 28. 32 00 33. Modified Colorado Adjusted Gross Income. Subtract line 31 from line 29. 33 00 34. Divide line 33 by line 32. Round to four significant digits, e.g. xxx.xxxx 34 % 35. Tax from the tax table based on income reported on the DR 0104 line 7 35 00 36. Apportioned tax. Multiply line 35 by the percentage on line 34. Enter here and on DR 0104 line 8. 36 00 Name SSN or ITIN * See the Individual Income Tax Guide and/or the Income Tax Topics: Part-Year Residents & Nonresidents for treatment of other additions.

*210104US19999* DR 0104US (09/30/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 1 2021 Consumer Use Tax Reporting Schedule Use this schedule to report consumer use tax due. This is one of three methods of filing to pay a consumer use liability. You may also use Revenue Online or file a DR 0252, Consumer Use Tax Return. See instructions or more information on how to file. What is Consumer Use Tax? Individuals and businesses are required to pay use tax on tangible personal property purchased from vendors either inside or outside of this state if the property is used, stored, or consumed within the state and sales tax was not collected or paid on the property. For more information on your consumer use tax obligation, including how to use the annual customer reports from non-collecting retailers, please visit Tax.Colorado.gov/Consumer-Use-Tax Special Districts also assess a use tax. More than half of Colorado residents live in one or more of these districts. The special districts that assess use tax and the applicable tax rates can be found at https://Colorado.TTR.Services. DO NOT CUT – If filing by paper, return full page WITH the 2021 DR 0104 form Name SSN or ITIN 1. Enter the total purchases for which state sales or use tax was not previously paid. 1 0 0 2. Multiply line 1 by 0.029. Enter the result in whole dollars here. 2 0 0 3. Enter the total purchases for which special district sales or use tax was not previously paid. 3 0 0 4. Enter the 2-digit SDCU Code for any applicable special district(s). See instructions. 4 5. Enter the corresponding use tax rate. See instructions. 5 6. Multiply line 3 by the rate on line 5. Enter the result in whole dollars here. 6 0 0 7. Add line 2 and line 6, transfer to the DR 0104 line 16. 7 0 0 DO NOT CUT – If filing by paper, return full page WITH the 2021 DR 0104 form

*210104CR19999* Form 104CR Individual Credit Schedule 2021 Taxpayer’s Last Name First Name Middle Initial SSN or ITIN Use this schedule to calculate your income tax credits. For best results, visit Tax.Colorado.gov to research eligibility requirements and other information about these credits before following the line-by-line instructions contained below. • Be sure to submit the required supporting documentation as indicated for each credit. • Most e-file software and tax preparers have the ability to submit this schedule and attachments electronically. However, Revenue Online can also be used to file your return and attachments electronically. Otherwise, include all required documents with your paper return. • If you received any of these credits from a pass-through entity, be sure to provide the entity’s name and account number and your ownership percentage where required. If credits were passed through from multiple entities, submit with your return a written statement that includes all relevant information. • Dollar amounts shall be rounded to the nearest whole dollar. Calculate percentages to the fourth decimal place. Round to four significant digits, e.g. xxx.xxxx Part I — Refundable Credits 1. Child Care Expenses Credit from the DR 0347, you must submit the DR 0347 with your return. 1 00 SSN Filers Only - Earned Income Tax Credit (EITC) - full or part-year Colorado residents who claim the federal EITC are allowed an earned income tax credit against their income tax. Complete the table for each qualifying child. Read the instructions in the 104 book and Income Tax Topics: Earned Income Tax Credit for additional guidance on completing this section. Only check the “Deceased” box for a qualifying child if the child was born and died in 2021 and was not assigned an SSN. You must submit a copy of the child’s birth certificate, death certificate, or hospital records showing a live birth with your return. 2. Enter the amount of Earned Income calculated for your federal return. 2 00 3. The federal EITC you claimed. 3 00 Qualifying Child’s Last Name Qualifying Child’s First Name Year of Birth SSN Deceased* *Check only if child was deceased before SSN was assigned in 2021, see instructions. DR 0104CR (09/30/21)

COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 4

4. COEITC, multiply line 3 by 10% (0.10) 4 00 5. Part-year residents only, multiply line 4 by the percentage on line 34 of the DR 0104PN (If the percentage exceeds 100%, use 100%.) 5 00 6. Business Personal Property Credit: Use the worksheet in the 104 Book instructions to calculate. You must submit copy of the assessor’s statement with your return. 6 00 7. Refundable Renewable Energy Tax Credit from line 85 of the DR 1366. You must submit the DR 1366 with your return. 7 00 8. ITIN Filers Only - Expanded Colorado Earned Income Tax Credit from line 20 (or 21) of form DR 0104TN. You must submit the DR 0104TN with your return. 8 00 9. Total Refundable Credits, sum of lines 1, 4 (or 5), 6, 7, and 8. Enter the sum on the DR 0104 line 25.

9 00 Part II — Credit for Tax Paid to Another State • Colorado nonresidents do not qualify for this credit. • Part-year residents generally do not qualify for this credit. • If you have income and/or losses from two or more states, you must separately calculate lines 11 through 17 for each state, regardless of whether any tax was paid on such income. If you do not file electronically, you must submit the DR 0104CR for each state. Then, enter “Combined” on line 10 and complete lines 11 through 17 to disclose the combined total for each line. A summary schedule is not acceptable. The Department strongly recommends electronic filing for taxpayers with credits for more than one state. Failure to file electronically may result in delays processing your return. Submit a copy of the tax return for each other state when claiming this credit. The portion of the return submitted must include the adjusted gross income calculation, any disallowed federal deductions by that state, and the tax calculation for the other state. 10. Name of other state: 11. Total of lines 8 and 9 Form 104 11 00 12. Modified Colorado adjusted gross income from sources in the other state, see FYI Income 17. 12 00 13. Total modified Colorado adjusted gross income 13 00 14. Divide line 12 by line 13. Round to four significant digits, e.g. xxx.xxxx 14 % 15. Multiply line 11 by the percentage on line 14 15 00 16. Tax liability to the other state 16 00 17. Allowable credit, the smaller of lines 15 or 16 17 00 DR 0104CR (09/30/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 4 *210104CR29999* Name SSN or ITIN

Part III — Other Credits Visit Tax.Colorado.gov for limitations that are specific to each credit. To report this properly, use the first column to report the total credit that is available (the amount generated this year plus any prior-year carryforward). Then, use the second column to report the amount you are using this year to offset your tax liability. Available Credit Column (A) Credit Used Column (B) 18. Plastic recycling investment credit, you must submit required receipts with your return. 18 00 00 Plastic recycling net expenditures amount (fill below): 19. Colorado Minimum Tax Credit 19 00 00 2021 Federal Minimum Tax Credit (fill below): 20. Carry forward of prior year Historic Property Preservation credit (per §39-22-514, C.R.S.). 20 00 00 21. Child Care Center Investment credit, you must submit a copy of your facility license and a list of depreciable tangible personal property with your return. 21 00 00 22. Employer Child Care Facility Investment credit, you must submit a copy of your facility license and a list of depreciable tangible personal property with your return. 22 00 00 23. School-to-Career Investment credit, you must submit a copy of the certification with your return. 23 00 00 24. Colorado Works Program credit, you must submit a copy of the letter from the county Department of Social/Human Services with your return. 24 00 00 25. Child Care Contribution credit, you must submit each DR 1317 with your return. 25 00 00 26. Long-term Care Insurance credit, you must submit a year-end statement to show premiums paid with your return. See FYI Income 37. 26 00 00 27. Aircraft Manufacturer New Employee credit, you must submit the DR 0085 and DR 0086 with your return. 27 00 00 28. Credit for Environmental Remediation of Contaminated Land, you must submit a copy of the CDPHE certification with your return. 28 00 00 29. Colorado Job Growth Incentive credit, you must submit certification from OEDIT with your return. 29 00 00 30. Certified Auction Group License Fee credit, you must submit a copy of the certification with your return. 30 00 00 31. Advanced Industry Investment credit, you must submit a copy of the certification with your return. 31 00 00 32. Affordable Housing credit, you must submit CHFA certification with your return. 32 00 00 DR 0104CR (09/30/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 3 of 4 *210104CR39999* Name SSN or ITIN

DR 0104CR (09/30/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 4 of 4 *210104CR49999* Available Credit Column (A) Credit Used Column (B) 33. Carry forward of prior year Credit for Food Contributed to Hunger-Relief Charitable Organizations, you must submit each DR 0346 and federal schedule F with your return. 33 00 00 34. Preservation of Historic Structures credit (per §39- 22-514.5, C.R.S.) carried forward from a prior year. 34 00 00 35. Preservation of Historic Structures credit (per §39-22- 514.5, C.R.S.), you must submit the certificate from OEDIT, History Colorado, or local granting authority with your return. 35 00 00 36. If you are claiming the Preservation of Historic Structures credit enter your credit certificate number issued by OEDIT, History Colorado, or local granting authority. 36 37. Rural Jump–Start Zone credit, you must submit certificate from Office of Economic Development AND the DR 0113 with your return. 37 00 00 38. Rural & Frontier Health Care Preceptor credit, you must submit your certification with your return. 38 00 00 39. Retrofitting a Residence to Increase a Residence’s Visitability Credit, you must submit certificate from Division of Housing. 39 00 00 If you are claiming a Retrofitting a Residence to Increase a Residence’s Visitability Credit, enter your credit certificate number issued by Division of Housing 40. Credit for employer contributions to employee 529 plan, you must submit DR 0289 with your return. 40 00 00 41. Credit for employer paid leave of absence for live organ donation. Employer must complete and submit form DR 0375 with their return. 41 00 00 42. Total of column A lines 18 through 41 (exclude line 36 certificate number) 42 00 43. Nonrefundable Credits Used, total of column B plus any amount from line 17, exclude line 36 certificate number. Also enter this amount on the DR 0104 line 12. Credit used cannot exceed credit available.

43 00 Name SSN or ITIN

Earned Income Tax Credit and the Child Tax Credit refunds may be available to you. Even if you earn little to no money, by filing your taxes you could receive these valuable tax refunds that can help you pay for groceries, rent, car repairs, clothes, or even to start a savings fund. CHILD TAX CREDIT (CTC) Grandparents raising grandchildren or parents with disabilities can receive up to $3,000 for every child ages 6 to 17 and $3,600 for every child under the age of 6. People who aren’t working or haven’t filed taxes recently or ever before can still get cash back. Colorado residents with social security numbers or individual taxpayer identification numbers (ITIN) can claim CTC refunds. Each child claimed must have a social security number. EARNED INCOME TAX CREDIT (EITC) Individual workers who are at least 25 but under 65 years of age can receive up to $1,500 in EITC payments. Workers raising children can receive up to $6,700 in EITC refunds. Individuals and families who earn up to $57,000 a year in income usually qualify for some amount of EITC credit. FILING YOUR TAXES IS EASIER THAN YOU THINK! VISIT GETAHEADCOLORADO.ORG TO GET STARTED FOR FREE.

Use this form to determine if you can claim the Colorado Child Care Expenses tax credit. You may be able to claim the credit if you pay someone to care for your dependent who is under age 13. For information about any federal form or publication listed below, please visit IRS.gov Eligibility To be able to claim the Colorado credit for child care expenses, you must file federal form 1040, 1040SR, 1040SP, or 1040NR and you (and/or your spouse) must have been a part or full-year resident of Colorado. Colorado non-resident filers may not claim this credit. If you did not file a federal income tax return, you may still be eligible for the Low Income Child Care Expenses credit. To claim the low income credit, you must complete and submit with your Colorado return, federal return and form 2441. You must also meet all of the following tests: 1. The care must be for one or more qualifying persons who are identified on federal form 2441. 2. You (and your spouse if filing jointly) must have earned income during the year. 3. You must pay child care expenses so you (and your spouse if filing jointly) can work or look for work. Qualifying expenses are defined under Section 21 of the Internal Revenue Code. 4. You must make payments for child care expenses to someone you (and your spouse) cannot claim as a dependent. If you make payments to your child, he or she cannot be your dependent and must be age 19 or older by the end of the year. You cannot make payments to: a. Your spouse, or b. The parent of your qualifying person if your qualifying person is your child and under the age of 13. 5. You cannot claim this credit if your federal filing status is Married Filing Separate. 6. You must identify the care provider on this form. It is recommended that you fully review IRS Publication 503 for eligibility tests and the definition of qualifying income and children. All of the information in this form is required and your credit may be denied if it is incomplete. Part I – Person or Organization Who Provided the Care Use this section to list the name, address and Social Security or Federal Employer ID number of the child care provider(s) you used. If you are unable to provide the Social Security or Federal Employer ID number of the child care provider, you must show that you attempted to obtain the required information by including such proof with this form. List the total amount paid for the full year of child care, paid to each provider. If you have more than two care providers or if the provider is non-profit, we strongly suggest you file your return electronically. Part II – Qualifying Child Information For lines 2a – 2d, list each qualifying child, their year of birth and their Social Security number. You must also list the amount of child care expenses for each specific child. Complete lines 2e through 4 as instructed on the form. If the amount on line 4 is greater than $60,000 do not continue because you do not qualify for this credit. If line 4 is $60,000 or less, enter the amount from line 9a of the IRS form 2441, Child and Dependent Care Expenses, on line 5 of this form DR 0347. For line 6 enter your tax from your federal income tax return. See IRS form 1040, 1040SR, 1040SP, or 1040NR line 18. If you claimed a Federal Child Care Tax Credit, continue to Part III. Otherwise, if you could not not claim a Federal Child Care Tax Credit and your adjusted gross income is $25,000 or less, skip to Part IV. If you have more than four qualifying children, we strongly suggest you file your return electronically. Part III – Child Care Expenses Credit For line 8 enter the amount from line 10 of IRS form 2441 or, if you were required to complete line 11 of IRS form 2441, the amount from line 11 of IRS form 2441. For line 9 multiply line 8 by the decimal on line 7. Full–year residents should enter amount from this form on line 9 to form DR 0104CR line 1. If you completed Part III and you were a part-year resident, continue to Part V. Part IV – Low-Income Child Care Expenses If you were unable to claim the Federal Child Care Tax Credit and the amount of line 4 is $25,000 or less, use Table A to calculate the credit. Otherwise, go back to Part III to calculate your credit. For line 11 multiply line 3 by the decimal on line 10. For line 12 enter the smaller amount of line 11 or the appropriate amount from Table A. Full–year residents should enter amount from this form on line 12 to form DR 0104CR line 1. If you completed Part III and you were a part-year resident, continue to Part V. Part V – Part Year Resident Limitation Complete this part only if you were a part-year resident of Colorado in 2021. Enter the percentage from the DR 0104PN line 34 on line 13 of this DR 0347. For line 14 multiple the amount from line 9 or line 12 by the percentage from line 13. Enter this amount on line 1 of the DR 0104CR. Child Care Expenses Tax Credit Instructions DR 0347 (01/18/22) COLORADO DEPARTMENT OF REVENUE Denver CO 80261-0005 Tax.Colorado.gov *DO=NOT=SEND*

DR 0347 (01/18/22) COLORADO DEPARTMENT OF REVENUE Denver CO 80261-0005 Tax.Colorado.gov Page 1 of 2 For Tax Year You MUST submit this form with your complete Colorado Individual Income Tax Return, including forms DR 0104 and DR 0104CR. You must also submit a copy of your federal income tax return and IRS form 2441 with your Colorado return. Thoroughly read the instructions to be certain you are eligible for this credit. Be sure to complete all required information. Failure to do so may result in a denied credit or delayed refund. Taxpayer Name SSN or ITIN Part I – Persons or Organizations Who Provided the Care – You must complete this part If you have more than two care providers or if the provider is non-profit, see the instructions. 1(a). Care Provider’s First Name or Business Name Last Name Middle Initial (b) SSN, ITIN or FEIN (c) Address City State ZIP (d) Amount Paid $ (e) Care Provider’s First Name or Business Name Last Name Middle Initial (f) SSN, ITIN or FEIN (g) Address City State ZIP (h) Amount Paid $ Part II – Qualifying Child Information – You must complete this part If you have more than four qualifying children, see the instructions. 2(a). Child’s First Name Last Name Middle Initial Year of Birth SSN or ITIN Qualified expenses you incurred and paid in 2021 for the person listed in 2(a) $ 2(b). Child’s First Name Last Name Middle Initial Year of Birth SSN or ITIN Qualified expenses you incurred and paid in 2021 for the person listed in 2(b) $ *210347==19999* 2021 Child Care Expenses Tax Credit

*210347==29999* DR 0347 (01/18/22) COLORADO DEPARTMENT OF REVENUE Denver CO 80261-0005 Page 2 of 2 Taxpayer Name Account Number 2(c). Child’s First Name Last Name Middle Initial Year of Birth SSN or ITIN Qualified expenses you incurred and paid in 2021 for the person listed in 2(c) $ 2(d). Child’s First Name Last Name Middle Initial Year of Birth SSN or ITIN Qualified expenses you incurred and paid in 2021 for the person listed in 2(d) $ 2(e). Enter the sum of all qualified child care expenses $ 2(f).Enter your earned income $ 2(g). If filing a joint return, enter the earned income of the other person $ 3. Enter the smallest of line 2(e), 2(f) [or 2(g) only if filing a joint return] 3 $ 4. Enter your adjusted gross income from your federal income tax return. See IRS form 1040, 1040-SR, 1040-SP, or 1040-NR line 11 4 $ If the amount of line 4 is greater than $60,000 STOP – you do not qualify for this credit. 5. Enter the amount from line 9a of IRS form 2441, child and dependent care expenses 5 $ 6. Enter your tax from your federal income tax return. See IRS form 1040, 1040-SR, 1040-SP, or 1040-NR line 18 6 $ Complete Part III if you claimed a Federal Child Care Tax Credit Part III – Child Care Expenses Credit 7. DO NOT complete this form if Line 4 is greater than $60,000. 7 0.50 8. Enter the amount from line 10 of IRS Form 2441 or, if you were required to complete line 11 of IRS Form 2441, the amount from line 11 of IRS Form 2441 8 9. Multiply line 8 by the decimal on line 7 9 Part IV – Low-Income Child Care Expenses Credit 10. Low-income calculation only. DO NOT complete this Part IV if line 4 is greater than $25,000 10 0 .25 11. Multiply line 3 by the decimal on line 10 11 Table A One qualifying child .............................. $500 Two or more qualifying children ...........$1,000 12. Enter the smaller of line 11 or the appropriate amount from Table A 12 Full-year residents should enter the appropriate amount from line 12 on Form 104CR line 1. Part-year residents skip to Part V Part V – Part-Year Resident Limitation 13. Part-year residents ONLY – enter the percentage from the DR 0104PN line 34. If percentage exceeds 100% from the DR 0104PN, line 34, enter 100% 13 % 14. Multiply the amount from line 9 or line 12 by the percentage from line 13. Enter the result on line 1 of the DR 0104CR 14 $

Page 47 Voluntary Contribution Eligible Funds A simple way to give. Complete form DR 0104CH Voluntary Contributions Schedule to contribute to any of these charitable funds. Colorado Nongame Conservation and Wildlife Restoration Cash Fund Nongame wildlife includes 750 species of wildlife that cannot be hunted, fished for or trapped. Funds go to projects that manage or recover wildlife such as lynx, river otter, black-footed ferret, green back cutthroat, and others. The nongame program receives no state tax dollars and depends on voluntary contributions. Domestic Abuse Program Fund Donations to this fund help support critical services provided by community-based domestic abuse programs across Colorado. These agencies provide 24-hour crisis line response, emergency safe shelter, counseling and advocacy services for victims of domestic violence and their children and information and referrals for their communities, and community education. Homeless Preventive Activities Program Fund Approximately 52,000 people in Colorado are at risk of becoming homeless this year. Keeping people in their homes saves tax dollars and is an effective and humane way of helping families in crisis. Your contribution will be used to support activities and programs which help prevent people from becoming homeless. Western Slope Military Veterans Cemetery Fund Funds assist in the maintenance of the Veterans Memorial cemetery of Western Colorado. The veterans cemetery is intended as a dignified final resting place for Colorado’s veterans and eligible dependents. It is a place of quiet contemplation for the veterans community. Please help maintain this solemn beauty for Colorado veterans. Pet Overpopulation Fund The Pet Overpopulation Fund provides funding to local animal care and control organizations and veterinarians for sterilization surgeries for pets owned by Coloradans in areas of the state with the greatest need. The Fund also supports efforts to educate the public about the importance of preventing pet overpopulation. Military Family Relief Fund Provides emergency grants for financial hardships to members of Colorado National Guard or Reservist and their families when ordered to Active Military duty and to Active Duty Military Personnel stationed in Colorado and their family members when the Active Duty military member is deployed to a declared hostile fire zone. American Red Cross Colorado Disaster Response, Readiness, and Preparedness Fund The American Red Cross prevents and alleviates human suffering in the face of emergencies. In Colorado, the Red Cross teaches tens of thousands of people lifesaving skills every year, provides critical services for members of the military and their families and responds to, on average, a disaster a day. Habitat for Humanity of Colorado Fund Seeking to put God’s love into action, Habitat for Humanity brings people together to build homes, communities and hope. Through volunteer labor and donations, Habitat for Humanity builds and rehabilitates simple, decent homes in partnership with hardworking low-income individuals and families in 45 Colorado communities. Special Olympics of Colorado Fund Special Olympics Colorado provides year-round athletic competition in 22 sports for over 19,000+ athletes with intellectual disabilities from 2 to 80+ years old. We create inclusive and welcoming schools for children with all differences through unified sports and youth leadership. Programs are free of charge to athletes and their families. Colorado Healthy Rivers Fund This fund protects Colorado’s lands and waterways. The state’s streams, wetlands, mountains and forests serve many needs including water supply, agriculture, wildlife and recreation. Your generous support of this program will fund stream restoration projects and assist local groups in watershed protection efforts. Remember, your contribution will make a difference! Alzheimer’s Association Fund One in 10 Coloradans over 65 and nearly half over 85 have Alzheimer’s disease with 70% cared for at home. 100% of your donation to the Alzheimer’s Association will fund essential education, training, and counseling services to urban and rural families. Without support, the emotional burden on caregivers is tremendous. Colorado Cancer Fund Cancer touches every Coloradan as it is the leading cause of death in our state. Your donation to the Colorado Cancer Fund assists Coloradans through education, prevention, treatment, and support programs. The Colorado Cancer Coalition, collaborating with over 250 organizations, administers the fund to lead the fight against cancer. Make-A-Wish Foundation® of Colorado Fund Since 1983, Make-A-Wish Foundation® of Colorado has given hope, strength and joy to over 3,300 Colorado children with life-threatening medical conditions. As one of 65 chapters in the U.S., and 27 inter- national chapters on five continents, Make-A-Wish Foundation® is the largest wish granting organization in the world. Unwanted Horse Fund Approximately 6,000 Colorado horses become unwanted each year because their owners no longer want them or can afford them. Abuse and abandonment are increasing whilst traditional outlets for unwanted horses—rescue facilities, therapeutic riding programs, etc., are reaching capacity. CUHA addresses the problem through grant programs, education initiatives and research. Urban Peak Housing and Support Services for Youth Experiencing Homelessness Fund Urban Peak provides shelter, supportive housing, street outreach, drop-in center services, education & employment training and other comprehensive support services to youths age fifteen through twenty-four who are experiencing homelessness in Colorado. Your contribution ensures that all Colorado youth have safe housing, supportive relationships and opportunities for self-sufficiency and success. Donate to a Colorado Nonprofit Fund For the first time ever, you can donate some or all of your state income tax refund to an eligible Colorado nonprofit of your choosing. It’s simple, fast, and puts you in charge of where your donation goes. Find the cause you’ll support here: coloradononprofit.dor.state.co.us or http://www.refundwhatmatters.org.

Please read all instructions before completing the forms. STATE OF COLORADO DEPARTMENT OF REVENUE Official State of Colorado Publication PRSRT STD U.S. POSTAGE PAID DENVER CO PERMIT NO. 212 PAYMENT WITHOUT Mail To COLORADO DEPARTMENT OF REVENUE Denver, CO 80261-0005 PAYMENT WITH Mail To COLORADO DEPARTMENT OF REVENUE Denver, CO 80261-0006 MAILING ADDRESS FOR FORM DR 0104 These addresses and zip codes are exclusive to the Colorado Department of Revenue, so a street address is not required.

*210104AD19999* DR 0104AD (10/22/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 1 of 2 2021 DR 0104AD – Subtractions from Income Schedule If claiming a subtraction and filing by paper, you must submit this schedule with your return. Use this schedule to report any subtractions from your Federal Taxable Income. These subtractions will change your Colorado Taxable Income from the amount of Federal Taxable Income. See instructions in the income tax booklet for additional guidance on completing this schedule. Do not enter negative amounts. You must submit this form along with the DR 0104 if claiming any subtractions. Name SSN or ITIN Subtractions from Federal Taxable Income 1. State Income Tax Refund from federal income tax form 1040, 1040 SR, or 1040 SP, Schedule 1 line 1. 1 0 0 2. U.S. Government Interest 2 0 0 3. Primary Taxpayer Pension, Annuity, IRA, Social Security, or Disability Income (see instructions) Deceased SSN or ITIN 3 0 0 4. Spouse Pension, Annuity, IRA, Social Security, or Disability Income (see instructions) Deceased SSN or ITIN 4 0 0 5. Primary Taxpayer Military Retirement Benefits (under age 55), you must submit copies of all 1099R statements with your return. (see instructions) 5 0 0 6. Spouse Military Retirement Benefits (under age 55), you must submit copies of all 1099R statements with your return. (see instructions) 6 0 0 7. Colorado Capital Gain Subtraction 7 0 0 8. CollegeInvest Contribution: (see instructions) Owner’s SSN or ITIN 8 0 0 Total Contribution Owner’s Name 9. Qualifying Charitable Contribution Total Contribution 9 $ 0 0 10. Qualified Reservation Income 10 0 0 11. PERA/DPSRS Subtraction, for PERA contributions made in 1984–1986 or DPSRS contributions made in 1986 11 0 0

*210104AD29999* DR 0104AD (10/22/21) COLORADO DEPARTMENT OF REVENUE Tax.Colorado.gov Page 2 of 2 Name SSN or ITIN 12. Railroad Benefit Subtraction 12 0 0 13. Wildfire Mitigation Measures Subtraction 13 0 0 14. Colorado Marijuana Business Deduction

14 0 0 15. Non-Resident Disaster Relief Worker Subtraction

15 0 0 Natural Disaster: Enter the executive order number(s) from the Colorado governor’s office that declared the state disaster emergency “D YYYY-###” (see instructions) 16. Reacquisition of Colorado Residency During Active Duty Military Service Subtraction 16 0 0 17. First Time Home Buyer Savings Account Interest Deduction, you must submit form DR 0350(s) with your return 17 0 0 18. Other Subtractions, explain below 18 0 0 Explain 19. Subtractions Allowed Under HB21-1002 (see instructions) 19 0 0 20. Subtotal, sum of lines 1 through 19, transfer the amount to line 6 on the DR 0104 20 0 0