Form Dr 5785 PDF Details

When managing taxes, the convenience of electronic transactions cannot be overstated, particularly for businesses and individuals obliged to navigate the complexities of tax payments. Enter the DR 5785 form, a crucial document for those opting to use Electronic Funds Transfer (EFT) for their dealings with the Colorado Department of Revenue. This form, a product of both convenience and necessity, takes center stage for taxpayers in Colorado looking to streamline their tax payment processes. Specifically designed to facilitate tax payments via EFT, it bears options for setting up a new account, modifying existing details, adding or removing taxes, and even adding additional EFT numbers. Crucial information from taxpayer identification to banking details, authorized signatures, and specific tax types and codes, is meticulously captured in this comprehensive form. Whether opting for ACH debit -- where the Colorado Department of Revenue initiates payments from the taxpayer's account -- or ACH credit -- where the taxpayer's bank sends funds to the Department of Revenue -- the DR 5785 form manifests as the linchpin for initiating these electronic transactions. Its versatility extends further, encompassing an array of tax types from individual income to special district sales, each with a designated code for precision and clarity in processing payments. All in all, the DR 5785 embodies an essential tool in the modern taxpayer's arsenal, providing a structured, secure, and straightforward pathway for fulfilling state tax obligations electronically.

QuestionAnswer
Form NameForm Dr 5785
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesLPG, CCD, unemployment colorado, ECK

Form Preview Example

DR 5785 (08/08/12) Web

 

Authorization For

 

EFT Number

COLORADO DEPARTMENT OF REVENUE

 

 

 

 

1375 Sherman Street

Electronic Funds Transfer (EFT)

 

 

 

Denver CO 80261

___ ___ ___ ___ ___ ___ ___ ___ ___ ___

(303) 205-8333

 

For Tax Payments

 

 

 

 

To be assigned by Department of Revenue

 

 

 

 

 

 

 

 

 

 

Taxpayer Name

 

 

Contact Person

 

 

 

 

 

 

 

Set Up New Account

Mailing Address (Street Number, Apt. Number, Box Number)

 

FEIN or Social Security Number

 

 

 

 

 

 

Modify Account

 

 

 

Telephone Number

 

 

 

 

 

 

 

 

 

(

)

 

Add Taxes

 

 

 

 

 

 

 

 

City, State, ZIP

 

 

Fax Number

Remove Taxes

 

 

 

(

)

 

 

 

 

 

Add Additional EFT Number(s)

 

 

 

 

 

 

Email Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tax To Be Paid by EFT Transactions.

 

 

 

 

Must be completed for either ACH debit or ACH credit.

 

 

 

See listing of taxes and tax type codes on reverse side.

 

 

 

 

 

 

 

 

 

 

 

 

Tax Type

 

 

 

Tax Type Code

 

Your DOR Account

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Complete Section 1 and/or 2

Section 1—ACH Debit

ACH Debit—taxpayer selects the EFT payment option on our web page or calls a toll free number

I hereby authorize the Colorado Department of Revenue (DOR), to initiate debit entries to my banking account. This authority is to remain in full force and effect until DOR and Financial Institution have received written notiication

from me of its termination in such time and in such manner as to afford DOR and FI a reasonable time to act on it. The use of an EFT identiication number and password will be required to convey my instructions for each transaction. The EFT identiication number and password may be used by me or by my agent. You will be able to

provide your banking information 24 hours after your registration for EFT.

Authorized Signature

Title

Date

Section 2—ACH Credit

ACH Credit—taxpayer initiates through own inancial institution.

I have contacted my inancial institution and conirmed the inancial institution can initiate Automated Clearing House credit transactions that meet Colorado Department of Revenue (DOR) requirements. For veriication, DOR

may contact:

Name of Bank

Bank Contact Person

Telephone Number

I hereby request DOR grant authority for the above named taxpayer to initiate Automated Clearing House credit

transactions to DOR's bank account. I understand these must be in the NACHA CCD+ format using the Tax Payment (TXP) Convention and may only be initiated for the tax types that have been registered for EFT payments with DOR.

Authorized Signature

Title

Date

Please return application to: Colorado Department of Revenue, CDO Research, 1375 Sherman Street, Denver CO 80261

or fax to (303) 866-3112.

Addendum To Authorization Agreement For Electronic Funds Transfer (EFT) For Tax Payments a Separate Tax Return Must be Filed For Most Tax Payments

Tax Type Description

Code

 

 

Delinquency/Bill Payment:

 

 

 

Individual Income Bill*

210

 

 

Severance Bill*

08405

 

 

Severance Withholding Bill*

01185

 

 

Excise:

 

 

 

Cigarette

072

 

 

Fuel Distributors

052

 

 

IFTA

059

 

 

IRP Registration

102

 

 

Liquor Excise

065

LPG Inspection Surcharge

0531

 

 

Passenger Mile

0532

 

 

PUC Fixed Utility Fees*

204

 

 

Tobacco Products

073

 

 

Winery Direct Shipper

06510

 

 

Fees:

 

 

 

New Tire Fee (Waste Tire Recycling)

121

 

 

Prepaid Wireless E911 Surcharge

049

 

 

Vehicle Daily Rental Fee

077

 

 

Gaming/ Racing:

 

 

 

Dog Racing*

1421

 

 

Gaming

141

 

 

Gaming Backup Withholding*

01114

 

 

Horse Racing*

1422

 

 

Racing Cash Fund*

1423

 

 

Racing Source Market Fee

140

 

 

Income:

 

 

 

Corporation

01312

 

 

Corporation Estimated*

01212

 

 

Corporation Extension*

01412

 

 

Estate/ Trust Estimated Income

01704

 

 

Fiduciary

017

 

 

Individual Income

01304

 

 

Individual Estimated*

01204

Tax Type Description

Code

 

 

Individual Extension*

01404

 

 

Pass-Through Entity

01320

 

 

Pass-Through Entity Estimated*

01220

 

 

Pass-Through Entity Extension*

01420

 

 

Wage Withholding*

011

 

 

Wage Withholding Annual Reconciliation

01102

 

 

1099 Withholding*

01105

 

 

1099 Withholding Annual Reconciliation

01106

 

 

Sales:

 

 

 

Aviation Fuel Consumer Use

05430

 

 

Aviation Fuel Retailer’s Use

05420

 

 

Aviation Fuel Sales

054

 

 

Consumer Use - Business

045

 

 

County Lodging

074

 

 

County Short Term Rental

04840

 

 

Local Marketing District

04810

 

 

Retailer’s Use

044

 

 

Sales

042

 

 

Sales Tax License Renewal*

242

 

 

Special District Sales

04202

 

 

Special Event Sales

04201

 

 

Severance:

 

 

 

Coal

08503

 

 

Coal Estimated*

08502

 

 

Metallic Minerals

08603

 

 

Metallic Minerals Estimated*

08602

 

 

Molybdenum

08613

 

 

Oil, Gas, & CO2

08403

 

 

Oil, Gas, & CO2 Estimated*

08402

 

 

Oil Shale

08103

 

 

Oil Shale Estimated*

08102

 

 

Severance Withholding*

01180

 

 

Severance Withholding Annual Reconciliation

01181

*Do not ile a tax return for these tax payments, the EFT transaction is the iling. For all other tax payments,

a tax return is required.

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