Form DR 0077 Fillable Enterprise Zone Certification -- Research/Development Expenditures
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

Colorado Department of Revenue Denver CO 80261 0005 Phone: (303) 238 SERV (7378) Colorado Office of Economic Development and International Trade 1625 Broadway Suite 2700 Denver CO 80202 SSN or FEIN *130077==29999* Amount of EZ research and development tax credit claimed boundaries of a Colorado Enterprise Zone and collects Businesses: Read FYI Publication Income 22 and calculate your Colorado Enterprise Zone credit using Certification Certification By Zone Administrator Check here if a certification has been filed for this facility in a prior year: Colorado Account Number (CAN) Date (MM/DD/YY) Department of Revenue that the above named facility is entirely within the designated Enterprise Zone Effective Date of Zone for this Location (MM/DD/YY) envelope if you mail the form to the Administrator For more information contact: For tax years 2012 and thereafter you must file electronically when claiming any Enterprise Zone credit form 112CR Complete the following information and form only if you are unable to complete the certification forward the signed form to the appropriate Enterprise I declare that all of the above information is true and correct to the best of my knowledge and belief I the duly authorized administrator of the above mentioned Enterprise Zone hereby certify to the State of Colorado information required by 39 30 103(4) C R S Use this Phone Number Phone: (303) 892 3840 www AdvanceColorado com/EZ Print Name process online at www AdvanceColorado com/EZ Research and development expenditures in zone during year See Department of Revenue "FYI" Publications for additional information: www TaxColorado com Signature of Authorized Company Official/Owner Signature of Zone Administrator Submit a copy of the certified form with your income tax return Tax Preparer or other contact for follow up information (please print) Taxpayer Signature This form certifies that your facility is located within the Title to the business Zone Administrator Include a stamped self addressed Zone Administrator: Verify the location of the facility then sign and date where indicated Return the certified form