2. City of Brighton Application for Voluntary Disclosure Agreement (VDA)

   The City of Brighton encourages businesses to voluntarily remit all sales, use, lodging, and other taxes owed to the City of Brighton. The Voluntary Disclosure Agreement (VDA) Program provides a full wavier of late penalties on delinquent remittances for eligible businesses. Please note that interest is still due. As part of the agreement the business will register to remit sales and use tax to the City going forward. To register a business go to Brightonco.Munirevs.com.

   If you have any questions or concerns about this process, please contact the tax and licensing division at SalesTax@Brightonco.gov or 303-655-2041.

4. Taxpayer Information

6. Company (Taxpayer)*
8. FEIN*
9. Primary Phone*
11. Mailing Address*
12. Apt. #
14. City*
15. State*
16. Zip Code*

18. Taxpayer’s Representative Information

20. Company (if different from Taxpayer)
22. Contact Name (Representative)*
23. Contact Title*
25. Primary Phone*
26. Extension
27. Email*
29. Mailing Address (if different from company)
30. Apt.#
32. City
33. State
34. Zip Code

36. Liability & Reporting Period

    (do not include periods for which you have already filed a City of Brighton Sales Tax Return)

38. Start Date*
39. End Date*

41. Estimated Taxes Owed

    (interest will be added to total due as part of the VDA agreement; penalty will be waived)

43. Tax Type*
    -- Select One --Sales & Use TaxLodging Tax
45. Taxable Sales in Brighton, CO*
46. Estimated Liability
47. Tax Collected*

49. Please answer each question fully. Failure to disclose all relevant information could result in the nullification of the agreement, loss of the reporting period, and denial of the waiver of delinquent penalty.

51. 1. Did the Company collect City of Brighton tax during the liability & reporting period?*

    1. Yes
    2. No
53. (Please explain below)
55. 2. Is the Company or its affiliated company(s) currently (or previously) licensed with the City of Brighton and/or have a sales tax account?*

    1. Yes
    2. No
57. (If yes, please provide license or account number)
59. 3. Is the Company or its affiliated company(s) under an audit by the City of Brighton (Colorado) or have you been previously contacted by the City for any tax due?*

    1. Yes
    2. No
61. (If yes, please explain below.)
63. 4. If the City of Brighton agrees to a Voluntary Disclosure Agreement, is the taxpayerwilling to provide records upon request by the City of Brighton to verify theinformation presented?If misrepresented or materially incorrect information ispresented, the City of Brighton may void the Voluntary Disclosure Agreement.*

    1. Yes
    2. No
65. 5. Nature of business activities in the City of Brighton*

    Describe the nature of the business, including what the business sells, the services it provides, the date the business or its predecessor started conducting business and any other facts that might have a bearing on tax liability.

67. 6. Determination of tax nexus*

    Describe the nature of the contact of the business with the City. Explain the reason or the change in circumstances that has caused the business to seek this agreement.

69. 7. Statement of past tax contacts with the City*

    Describe any recent contact between the City and the business. Has the business been contacted by the City recently with respect to the filing of taxes and/or is the company now under audit?

71. By checking the box below you acknowledge the following:*

    1. To the best of my knowledge, this request for a voluntary disclosure agreement is accurate and complete, and any and all pertinent information has been disclosed. I understand that any misrepresentation may result in the nullification of an agreement, the loss of a limited reporting period, and the loss of penalty waiver. I understand I will be re-directed to the secure link brightonco.gov/taxdocs to submit the supporting documentation needed to review this application.
Leave This Blank:


73. 1. Receive an email copy of this form.
74. Email address

    This field is not part of the form submission.

75. Submit

* indicates a required field