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                                                   DR 0021X (07/13/22) 
                                                   COLORADO DEPARTMENT OF REVENUE 
                                                   Denver CO 80261-0006 
*DO=NOT=SEND*                                      Tax.Colorado.gov

                      2022 Amended Colorado Oil and Gas Severance 
                                                         Tax Return

                                                         Instructions

The Amended Colorado Oil and Gas Severance                         a mutual fund, brokerage firm, or credit union) in the United 
Tax Return (DR 0021X) is required to be used when                  States.
correcting your Colorado Oil and Gas Severance Tax                 How do I use Direct Deposit?
Return (DR 0021).                                                  The routing number must be nine digits. The account 
                                                                   number can be up to 17 characters (both numbers and 
Statute of Limitations
                                                                   letters). Include hyphens but omit spaces and special 
The statute of limitations for filing a Colorado severance 
                                                                   symbols.
tax claim for refund is generally three years from the due 
date of the original return or three years from the date of 
last tax payment for the year involved, whichever is later.
Refund for Deceased Taxpayer
To request a refund for a deceased taxpayer, write 
“deceased” across the top of the return and the date of 
death next to the deceased person’s name. Additionally, 
you must sign the return and write “filling as surviving 
spouse” or “filling as legal representative” by your signature.
Any person other than the surviving spouse who files 
a return and requires a refund on behalf of a deceased 
person must include a copy of the death certificate and the        You should contact your financial institution to ensure 
DR 0102, Claim for Refund for Deceased Taxpayer.                   your deposit will be accepted and to obtain the correct 
Colorado Account Number                                            routing and account numbers. This is especially important 
For business accounts, enter your Colorado account                 if you want your refund deposited to a savings account 
number and your Federal Employer Identification Number             at a credit union. The Department of Revenue is not 
(FEIN) in the spaces provided. For individuals, enter your         responsible for a lost refund if you enter the wrong 
Social Security number or ITIN.                                    account information. Any refund claim that, for any reason, 
                                                                   cannot be deposited into the account specified will be 
Lines 11 through 17 
Compute the amount owed to the state on the amended                issued and mailed in check form instead.
return. Any decrease in the amount of the overpayment              Interest
(line 11) or increase in the amount owed (line 12) will            If the return is amended after the original due date of the 
indicate that an amount is owed with the amended return.           return, interest at the applicable statutory rate will accrue 
To pay the amount you owe, write your Colorado account             on any balance of tax due until paid. Interest rates are 
number or Federal Employer Identification Number (FEIN)            published on our web site at Tax.Colorado.gov
on your check. Enclose but do not attach your payment with         Penalty
DR 0021X.                                                          The penalty on any balance of tax due is $30 or 30% of 
Lines 18 through 21                                                the balance of tax due, whichever is greater.
Compute the amount of credit available on the amended              Reason for amended return
return. Any increase in the amount of the overpayment              Include an explanation and any documentation, including 
(line 18) or decrease in the amount owed (line 19)                 schedule DR 0021D, and DR 0021PD, if applicable, 
will indicate that an overpayment is available with the            needed to substantiate the changes reported on the 
amended return. The overpayment can be credited to                 amended return.
estimated tax (line 21) for the tax year following the period 
on the amended return, or can be requested as a refund             Forms and Information
(line 20).                                                         If you have any questions you may call the Department of 
                                                                   Revenue at (303) 238-SERV (7378) or see our web site at 
Direct Deposit                                                     Tax.Colorado.gov for forms and information.
The department can deposit your refund directly into your 
account at a U.S. bank or other financial institution (such as 



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                                            DR 0021X (07/13/22) 
                                            COLORADO DEPARTMENT OF REVENUE 
                                            Denver CO 80261-0006 
*220021X=19999*                             Tax.Colorado.gov
                                            Page 1 of 2

       2022 Amended Colorado Oil and Gas Severance Tax Return
                                                                                                                                   (7102)
For Taxable Year (2022)                     Fiscal Tax Year Beginning (MM/22)                        Fiscal Tax Year Ending (MM/YY)

                 2022
Last Name or Business Name                                              First Name                                                 Middle Initial

                           SSN or ITIN                                  Colorado Account Number (if applicable)
Deceased                Yes

If Joint, Spouse or Partner Last Name (see controlled group definition) First Name                                                 Middle Initial

                           SSN or ITIN                                  FEIN (if applicable)
Deceased                Yes

Address

Foreign Country                             City                                   State             ZIP       Phone Number

If this is a final return, check this box   Are you a producer of Colorado Oil or Gas?                         Yes                  No

Check one:                 Cash Basis Filer                Accrual Basis Filer

Tax and Credit – Complete schedule DR 0021D first. Include the DR 0021D with this form when you file     Round to the nearest dollar

1.  Oil and gas tax, enter amount from line 5, DR 0021D                              1               $                              00

2.  Impact assistance credit                                                         2               $                              00

3.  Net tax, line 1 minus line 2 but not less than zero                              3               $                              00
                                                       Prepayments

4.  Severance tax withheld, include form(s) DR 0021W                                 4               $                              00

5.  Estimated tax and extension payments                                             5               $                              00

6.  Total Prepayments, sum of lines 4 and 5                                          6               $                              00
    Stop here to let the department calculate your refund or balance due. Otherwise, manually complete the return 
Stop
    yourself and continue with line 7. 

7.  If line 6 is larger than line 3, enter your overpayment                          7               $                              00

8.  Enter the overpayment from your original return or as previously adjusted        8               $                              00

9.  If line 3 is larger than line 6, enter the amount owed                           9               $                              00

10. Enter the amount owed from your original return or as previously adjusted       10               $                              00



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                                                 DR 0021X (07/13/22) 
                                                 COLORADO DEPARTMENT OF REVENUE 
                                                 Denver CO 80261-0006 
*220021X=29999*                                  Page 2 of 2
                                            Compute the amount you owe

11. Line 8 minus line 7, but not less than zero                             11   $                              00

12. Line 9 minus line 10, but not less than zero                            12   $                              00

13. Additional tax due, total of lines 11 and 12                            13   $                              00

14. Interest due on additional tax                                           14  $                              00

15. Penalty due                                                              15  $                              00

16. Estimated tax penalty due                                                16  $                              00
                                                              
17. Payment due with this return, sum of lines 13 through 16   Paid by EFT   17
                                                                                 $ 
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.
                                                 Compute your refund

18. Line 7 minus line 8 but not less than zero                                18 $                              00

19. Line 10 minus line 9, but not less than zero                              19 $                              00

20. Refund claimed with this return, sum of lines 18 and 19                   20 $                              00
21. Overpayment credited to next year’s estimated tax 
    (Do not include this amount on line 20)                                   21 $                              00

                    Routing Number                                    Type:     Checking  Savings
     Direct
     Deposit        Account Number

Reason for Amendment

Last Name of person preparing return                          First Name                                        Middle Initial

Address of person preparing return                                       Phone Number

City                                                                                      State     ZIP

Under penalty of perjury in the second degree, I declare that I have examined this return and to the best of my 
knowledge and belief it is true, correct and complete. 
Signature of Individual Taxpayer                                                     Date (MM/DD/YY)

Spouse’s Signature                                                                   Date (MM/DD/YY)

     Signature of Corporate Officer                                                  Date (MM/DD/YY)

     Mail to and make checks payable to:         Colorado Department of Revenue, Denver, CO 80261-0006






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