Form DR0104PTC "Colorado Property Tax/Rent/Heat Rebate Application" - Colorado

What Is Form DR0104PTC?

This is a legal form that was released by the Colorado Department of Revenue - a government authority operating within Colorado. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 19, 2017;
  • The latest edition provided by the Colorado Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DR0104PTC by clicking the link below or browse more documents and templates provided by the Colorado Department of Revenue.

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Download Form DR0104PTC "Colorado Property Tax/Rent/Heat Rebate Application" - Colorado

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(09/07/17)
104PTC
Booklet Includes:
Instructions
DR 0104PTC Application and Affidavit
Property Tax/Rent/Heat Rebate
Colorado Property Tax/Rent/Heat
Rebate Filing Guide
You might qualify for the PTC if you are:
At least 65 years old
A single person
or
with total income of
less than $13,608
A surviving spouse at
A
least 58 years old;
or
Colorado
or
A married couple
resident
Disabled for all of 2017,
with total combined
regardless of age, and
income of less
received benefits for
than $18,343
the full year.
Proving lawful U.S. presence is mandatory
Applicants 18 years old or older must sign the affidavit of the PTC application and list
their valid Colorado driver license or ID number on the application. You must have a
Colorado State-issued driver license or ID card before applying for the PTC. See the last
page of this booklet for more information about lawful presence.
Read all instructions before completing
the application, forms and affidavit.
(09/07/17)
104PTC
Booklet Includes:
Instructions
DR 0104PTC Application and Affidavit
Property Tax/Rent/Heat Rebate
Colorado Property Tax/Rent/Heat
Rebate Filing Guide
You might qualify for the PTC if you are:
At least 65 years old
A single person
or
with total income of
less than $13,608
A surviving spouse at
A
least 58 years old;
or
Colorado
or
A married couple
resident
Disabled for all of 2017,
with total combined
regardless of age, and
income of less
received benefits for
than $18,343
the full year.
Proving lawful U.S. presence is mandatory
Applicants 18 years old or older must sign the affidavit of the PTC application and list
their valid Colorado driver license or ID number on the application. You must have a
Colorado State-issued driver license or ID card before applying for the PTC. See the last
page of this booklet for more information about lawful presence.
Read all instructions before completing
the application, forms and affidavit.
Page 3
Do you qualify for the PTC Rebate?
Step 1
Did you live in Colorado from January 1–December 31, 2017? If you visit family out of state, but return to your Colorado
home, you are still a Colorado resident. Yes. Continue to STEP 2. No.
You do not qualify for the PTC.
Step 2
Is your TOTAL income from all sources less than the amounts in the table below?
Single
$13,608
Married (combined income) $18,343
Yes. Continue to STEP 3. No.
You do not qualify for the PTC.
Step 3
As of December 31, 2017, did you meet one of the age criteria in the list below? If married, at least one person has to
meet the criteria.
• Age 65 or older, or
• A surviving spouse, age 58 or older. If you were divorced before your spouse died, you are not considered a
surviving spouse and must therefore meet one of the other age criteria, or
• A disabled person of any age who was unable to engage in any substantial gainful activity for medical reasons.
You also must have qualified for full benefits from January 1–December 31, 2017 from a bona fide public or
private plan or source, based solely on your disability.
Yes. Continue to STEP 4. No.
You do not qualify for the PTC.
Step 4
Were you lawfully present in the United States during 2017? Applicants 18 years old or older must have a valid
Colorado driver license or ID card, and must supply the number on their PTC application. See the last page of this
booklet for more information. Yes. Continue to STEP 5. No.
You do not qualify for the PTC.
Step 5
Did you pay property tax, rent or heating bills during this PTC period? Yes. Continue to STEP 6. No.
You do not
qualify for the PTC.
Step 6
Were you claimed as a dependant on someone else’s federal income tax return? Yes.
You do not qualify for the PTC.
No. You qualify. Continue to the application.
When will my rebate be issued?
The Colorado PTC Rebate is paid on a set schedule based on when your application is processed. This payment
schedule is set by law and we cannot make any exceptions, except that any processing or payment dates that fall on
the weekend will instead happen on the next business day. We recommend that you file in January or early February.
For faster delivery of your rebate, we recommend that you sign up for Direct Deposit (see page 5). Please review the
application/payment chart below.
Application received,
Anticipated
Anticipated
Number
Amount of Each
approved, and processed
Direct Deposit
Paper Check
of Equal
Installment Payment
before
Payment Dates
Payment Dates
Installments
March 10, 2018
April 5, 2018
April 15, 2018
1/4 of total rebate
4
June 10, 2018
July 5, 2018
July 15, 2018
1/3 of total rebate
3
September 10, 2018
October 5, 2018
October 15, 2018
1/2 of total rebate
2
December 10, 2018
January 5, 2019
January 15, 2019
Full rebate
1
December 31, 2019
10 weeks after receipt
12 weeks after receipt
Full rebate
1
Do not call prior to these dates.
Example: Mary Jones mails her application on January 20, 2018, she selects Direct Deposit and her application is received
and approved before March 10, 2018. She will receive 4 equal payments, one of each being deposited in her account by
4/5/18, 7/5/18, 10/5/18 and 1/5/19.
Deadline for filing your application
Applications for the Colorado PTC Rebate for calendar year 2017 must be filed by December 31, 2019. Applications
received after that date will be denied.
Page 4
Instructions
For more information about the PTC Rebate, read publication FYI General 2 for Privacy Act Notice and FYI General 7 on
Colorado.gov/Tax, the Taxation Division's informational website. Enter information for the 2017 calendar year only. Combining
information from other years will cause your application to be delayed or denied.
• Names—Enter your legal name as it appears on your driver license or ID card.
• Civil Unions — Parties to a Civil Union must file as married.
• Physical address — If you did not live at this address for the full year, attach a list of all the places you lived throughout
this year. Be sure to include the dates you lived at each location.
• Mailing address — Be certain this is your current mailing address, otherwise you may not receive your rebate.
• Driver license or ID number and expiration date —The Department might request additional proof of Colorado residency
if your license or ID was not valid for the full year.
• Email address, if you have one.
• Confirm your eligibility by checking the appropriate box. Check only one box. If you check box D, attach a copy of your
disability statement that is less than 90 days old. The statement must be provided by the agency that pays the benefits.
Veterans Administration Award letters must show the disability percentage at 50% or more.
• First-time filers must provide proof of full-year Colorado residency. If you did not hold your Colorado driver license or ID
card from January 1–December 31, 2017, you must attach a copy of your lease or rental agreement.
Income
Line 1
Enter the number of months (1–12) you were covered by Medicare. If your premiums were paid by Medicaid or
if you were not on Medicare, enter 0.
Lines 2-6 Enter the gross income you received for each item listed. Do not list only the taxable portion. The gross amount
should be clearly identified on the statement(s) you received from the payor. Do not include Medicare benefits
on line 2 if they were paid on your behalf by a third party.
Line 7
Review the tables below and report any income you received from these sources that is not already included on
lines 2-6.
You must report this income:
AFDC or TANF Received (exclude payments received for dependents)
Life Insurance Distributions (exclude funeral expenses)
Alimony
Lottery and Gambling Winnings
All Taxable Income
Old Age Pension (OAP)
Capital Gains
Rental Income or Loss (exclude expenses, but not depreciation)
Commissions
Royalties
Disability Insurance Settlements
Stock Dividends or Rights (only if reported on federal income tax return)
Disability Payments
Tier 1 & 2 Railroad Retirement
Farm Income or Loss (exclude expenses, but not depreciation)
Veterans Benefits
Inheritance
Worker’s Compensation
Do not report this income:
Capital Losses or Return of Capital
Home Care Allowances or Adult Foster Care Assistance
Child Support Received
Income Tax Refunds
Colorado PTC Rebates Received
Veterans Service-connected Disability (permanent)
Gifts
Welfare Payments Received for Dependent Children (AFDC, etc.)
Heat/Fuel Assistance such as LEAP
Expenses
Line 8
Enter the total amount of property tax paid, if any. DO NOT include any supplement/assistance that was paid by
the Senior Homestead Exemption. Include only taxes that you paid in the calendar year 2017.
Line 9
Enter the total rent you paid for January 1–December 31, 2017, if any.
Line 10
Enter the total heat/fuel expenses you paid to heat your home during 2017, if any. DO NOT include any heat/
fuel expenses that were included in your rent payment.
Line 11
Check the appropriate box to indicate whether your meals were included in your rent. If meals were included for
only part of the time you paid rent, enter how much rent was paid when your meals were included.
Line 12
Check the appropriate box to indicate whether you lived in a property tax exempt home. If your home was
property tax exempt for only part of the year, enter how much rent was paid when your home was property
tax exempt.
Line 13
Check the appropriate box to indicate whether your heat/fuel was included in your rent. If heat/fuel was included
for only part of the time you paid rent, enter how much rent was paid when your heat/fuel was included.
Page 5
Direct Deposit
You are not required to enroll in Direct Deposit, but it is highly recommended. For faster processing of your rebate, enter
the routing and account numbers and account type. 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.
Intercepted Rebates
The Department will intercept your rebate if you owe back taxes or if you owe a balance to another Colorado government
agency. If you are filing a joint return and only one party is responsible for the unpaid debt, you may file a written claim to
Injured Spouse Desk, 1375 Sherman St, Room 240, Denver, CO 80261. Claims must include copies of all W-2, W-2G, any
1099 and/or TPQY statements received by both parties. DO NOT attach your claim to this application. It will not be processed.
Signature(s)
Sign and date your application. Failure to sign and date your application will cause delays and/or denial of your rebate.
Affidavit
Complete the affidavit for lawful U.S. presence.
Special Circumstances
Disabled Children: Complete the following to calculate the PTC rebate for disabled children:
a) Enter the total income for the disabled child.
$
b) Enter the total income for the household, including the disabled child.
$
%
c) Divide line A by line B. Enter the result.
Multiply the amount of property tax, rent, and/or heat/fuel expenses by the amount on line c. This is the child’s portion of the expense.
Example: Jose is a disabled child under age 18, who received $6,000 in SSI this year. His parents do not meet the
age criteria for the PTC Rebate, but earned $8,000 from wages this year. The family pays $3,600 in rent and $300
heat/fuel to heat the home.
a) $6,000
b) $14,000
c) 42.9%
Line 9 of Jose’s application is $1,544 ($3,600 x 0.429) and line 10 is $129 ($300 x 0.429).
Married Persons: If you were legally married but never divorced, then you are still considered married. This is true even if
you have a legal separation. If you are married, you MUST include all information about your spouse including all income and
expenses s/he had in 2017. (Unless one spouse within a married couple resides in a nursing home/assisted living center,
see the next page for more details.)
Non-married Persons Sharing a Home: If you share a home with another adult and you share the expenses of the home,
please note the following:
Property Tax
One Owner: Only the owner of the home should enter the property tax amount on their application. If the other person
living in the home pays the owner rent, the owner must report the rent as income on line 7 and the renter can report
the rent expense on their application on line 9.
or
Joint Ownership: Each owner may enter the property tax amount they paid on their own application. The amount
should be calculated according to their ownership percentage in the property. Enter the appropriate amount on line 8
of each person’s application.
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