Departmental Use Only      DR 0235 (07/16/14)
                                        COLORADO DEPARTMENT OF REVENUE
                                        Denver CO 80261-0013
                                        (303) 238-SERV (7378)

                                        Request for Vending Machine Decals
                                                             (see information on the reverse side)

        *140235V219999*

Account Number (state sales tax number)                   Period (MM/YY-MM/YY)
                                                                                   -
Name of Business Requesting Decals

Location Address                                             City                                 State Zip

Decal Information

0190-190         Number of decals requested                       x    10 cents = (999) $
If your check is rejected due to insufficient or uncollected funds, the Department of Revenue may collect the payment 
amount directly from your banking account electronically. 
Businesses Where Machines are Located 
Business Name

Address                                                      City                                 State Zip

Business Name

Address                                                      City                                 State Zip

Business Name

Address                                                      City                                 State Zip

Business Name

Address                                                      City                                 State Zip

Business Name

Address                                                      City                                 State Zip

Business Name

Address                                                      City                                 State Zip

Business Name

Address                                                      City                                 State Zip

Business Name

Address                                                      City                                 State Zip

Business Name

Address                                                      City                                 State Zip

                                   Photocopy and submit additional pages as needed.

                                              Instructions

Definition                                                Taxability of Items
 A vending machine is a money-operated (coins or           Items selling for 15 cents or less are exempt from sales 
 bills) machine offering personal property and/or food     tax. If the item vends for more than 15 cents, you may 
 to a consumer. Video games, pinball machines or pool      not calculate the sales tax you remit by subtracting the 
 tables are not included in this definition.               first 15 cents from the items you sell. For example, if 
                                                           the tax rate is 6.4 percent, a $1.00 item includes the 
Licensing                                                  tax of six cents. 
                                                           ($1.00 ÷ 1.064 = 94 cents; .94 x .064 = 6 cents.)
 If you have the key to the vending machine money box 
 and you collect the money from the vending machines, 
                                                          Exemption from Tax Liens
 you must obtain a Colorado Sales Tax License.
                                                           You may apply for tax lien protection only if you are 
 If you plan to have machines at more than one location, 
                                                           leasing a vending machine. The lease must not give 
 the $16 sales tax license fee will apply to your first 
                                                           the retailer any right of ownership to the machine(s). If 
 or principle location and to all your branch locations. 
                                                           the retailer has part or full ownership of the machine(s), 
 Only one license is required for all your locations. You 
                                                           the vending machine(s) will not be exempt from tax 
 may submit your application and fee to any Taxpayer 
                                                           liens on the retailer's property. [39-26-205(3) C.R.S.]
 Service Division District Office or mail the application 
 and fee to the Colorado Department of Revenue,            To qualify for the exemption, you must send the 
 Denver, CO 80261-0013.                                    Department of Revenue a listing by serial number of 
                                                           your vending machines. The list must include your 
Identification Decals                                      name, the name and address of your business, and 
                                                           your business telephone number.
 At the time you obtain your sales tax license, you are 
 required to purchase identification decals for your       You must also mark your vending machines using 
 machine(s). Each decal costs 10 cents. [39-26-714         numbers or other identification marks. The numbers 
 C.R.S.]  To obtain the decals you must complete a         or marks you use on each machine must correspond 
 form DR 0235 (Request for Vending Machine Decals).        to the list of vending machines you send to the 
                                                           department. You may choose your own numbering or 
 You must place one decal on each machine. The decal 
                                                           marking system. The numbers or marks should be in 
 should be placed on the front or side of the machine 
                                                           an accessible location on the vending machine so that 
 and should be visible and accessible. The decal makes 
                                                           Department of Revenue agents can identify the machine 
 it possible for Department of Revenue agents to identify 
                                                           as one that is protected from tax liens. These numbers 
 the machine and its owner.
                                                           or marks are different from the vending machine decals 
                                                           which you must purchase for your machines.