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DR 21X (09/02/04) (55) 16 COLORADO DEPARTMENT OF REVENUE DENVER CO 802610007 www.taxcolorado.com AMENDED COLORADO SEVERANCE TAX RETURN TAXABLE YEAR BEGINNING, ENDING, DO NOT WRITE ABOVE THIS LINE
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Read the instructions carefully before you begin filling out the DR 21 Severance 01 form.
02
Enter your personal information, such as your name, address, and contact details, in the designated sections.
03
Provide details about your employment, including your position, the company name, and your dates of employment.
04
Indicate whether you are eligible for severance benefits according to the terms of your employment agreement or the company's severance policy.
05
Specify the amount of severance pay you are requesting or the terms of the severance package you are seeking.
06
If applicable, provide reasons for seeking severance pay, such as layoff, termination, or a mutual agreement between you and your employer.
07
Attach any supporting documentation, such as employment contracts, termination letters, or relevant correspondence.
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Review the completed form to ensure accuracy and completeness.
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Sign and date the form as required.
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Submit the filled-out DR 21 Severance 01 form to the appropriate department or entity as instructed in the form's instructions.

Who needs dr 21 severance 01?

01
Employees who have recently been laid off or terminated from their jobs and believe they are entitled to severance pay.
02
Employees who have a severance agreement as part of their employment contract.
03
Employees who have a company-wide severance policy in place that provides severance benefits.
04
Employees who have mutually agreed with their employer to separate their employment and seek severance benefits.
05
Employees who have experienced a significant change in their job or employment conditions that makes them eligible for severance benefits as defined by their employer.
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dr 21 severance 01 is a form used to report severance payments made to employees.
Employers who have made severance payments to employees are required to file dr 21 severance 01.
To fill out dr 21 severance 01, employers need to provide details of the severance payments made to each employee.
The purpose of dr 21 severance 01 is to report severance payments made to employees and ensure compliance with tax regulations.
Information such as the employee's name, social security number, amount of severance payment, and date of payment must be reported on dr 21 severance 01.
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