DR 0103 (11/22/22)
                                              COLORADO DEPARTMENT OF REVENUE
                                              Denver CO 80261-0013
*DO=NOT=SEND*                                 Tax.Colorado.gov

                     Service Fee Worksheet

General Information                                             Line 4.
                                                                Enter the sum of the balance due/amount owed on all sites/
If you are filing the Sales Tax Return (DR 0100) or the 
                                                                returns for this period. The balance due appears on line 18 
Aviation Fuel Sales Tax Return (DR 1510) after the due 
                                                                of form DR 0100 and line 15 of form DR 1510.
date of the return, do not complete this form. Returns filed 
and paid late are not eligible to retain the state service fee. Checkboxes:
                                                                Check the applicable box and complete the applicable lines 
Electronic Filing                                               as instructed.
Retailer's can avoid completing the paper DR 0103 by filing     Line 5.
electronically through Revenue Online. Revenue Online           Multiply line 2 by .04. Enter result.
can be accessed at Colorado.gov/RevenueOnline.
                                                                Line 6.
Form Instructions                                               If line 1 is between $100,001 and 862,069. Subtract line 5 
                                                                from line 3. Enter result on line 6 and on line 10.
Retailer's must enter their eight digit Colorado account 
number, their name, and their filing period.                    Line 7.
                                                                This is the maximum state service fee allowed, $1,000.
Line 1.
Enter the sum of all net taxable sales for all sites/returns    Line 8.
for this period. The net taxable sales appears in the state     If line 1 is between $862,070 and $1,000,000. Subtract 
column on line 5 on form DR 0100 and on line 6 on form          line 7 from line 3. Enter result on line 8 and on line 10.
DR 1510.                                                        Line 9.
Line 2.                                                         If line 1 is more than $1,000,000. Enter amount from line 3 
Enter the sum of the tax on net taxable sales for all sites/    on line 9 and on line 10.
returns for this period. The tax appears in the state column    Line 10.
on line 7 of form DR 0100 and on line 8 of form DR 1510.        Amount from line 6, 8 or 9.
Line 3.                                                         Line 11.
Enter the sum of all state service fees calculated on all       Add line 4 and line 10.
sites/returns filed for this period. The state service fee 
appears in the state column on line 11 of form DR 0100 
and on line 10 of form DR 1510. Do not include any service 
fees calculated and claimed for any state-administered 
local jurisdictions. 

                                                    DR 0103 (11/22/22)
                                                    COLORADO DEPARTMENT OF REVENUE
                                                    Denver CO 80261-0013
*220103==19999*                                     Tax.Colorado.gov
                                                    Page 1 of 1

                                           Service Fee Worksheet

Use this worksheet to determine if any portion of the state service fee must be "added" back and included in the balance 
to be paid with form DR 0100 or DR 1510.  
Colorado Account Number (XXXXXXXX-XXX-XXX)                                                                Period (MM/YY-MM/YY)

Name

                                                                                                          (C1-1)
1.   Total net taxable sales. Sum of line 5-1 for all sites on form DR 0100 or line 6-1 for all sites 
    on form DR 1510.  
                                                                                                          (C2-1)
2.   Tax on net taxable sales. Sum of line 7-1 for all sites on form DR 0100 or line 8-1 for all sites on 
    form DR 1510.
                                                                                                          (C3-1)
3.    Sum of all state service fees. Sum of line 11-1 for all sites on DR 0100 or line 10-1 for all 
    sites on form DR 1510.
                                                                                                          (C4-1)
4.    Amount owed before addbacks. Sum of line 18 for all sites on form DR 0100 or line 15 for all 
    sites on form DR 1510.
                                                                        If line 1 is between $862,070 and $1,000,000. The 
    If line 1 is $100,000 or less. No addback due. 
                                                                        $1,000 Service Fee Limit Addback is due. Complete 
    Do not complete this form.                                          lines 7 and 8.
    If line 1 is between $100,001 and $862,069. The 
                                                                        If line 1 is more than $1,000,000. The $1,000,000 
    4% Service Fee Addback is due. Complete lines 5 
                                                                        Taxable Sales Limit Addback is due. Complete line 9.
    and 6.
4% Service Fee Addback
                                                                                                          (C5-1)

5.  Service fee at 4%. Line 2 multipled by .04.
                                                                                                          (C6-1)
6.   If line 1 is between $100,001 and $862,069, subtract line 5 from line 3. Enter amount here 
    and on line 10. 
$1,000 Service Fee Limit Addback
                                                                                                          (C7-1)

7.  Maximum state service fee.                                                                                   $1,0 0 0 0 0
                                                                                                          (C7-1)
8.    If line 1 is between $862,070 and $1,000,000, subtract line 7 from line 3. Enter amount here 
    and on line 10.
$1,000,000 Taxable Sales Limit Addback
                                                                                                          (C7-1)

9.  If line 1 is more than $1,000,000, enter amount from line 3 here and on line 10.
                                                                                                          (C7-1)

10. Addback owed. Amount from line 6, 8 or 9.
                                                                                                          (C7-1)

11. Total due for all sites. Add line 4 and line 10.