Form 53-C - Consumer'S Use Tax Return - 2017
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Form
Missouri Department of Revenue
53-C
Consumer’s Use Tax Return
RETE
RETE
Missouri Tax Identification Number
Federal Employer Identification Number (FEIN)
Select one if:
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Amended Return
Additional Return
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Owner Name
Business Name
Reporting Period
Mailing Address
City
State
ZIP Code
Business Phone Number
Due Date
Office Use Only
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Address Correction:
Mailing Address
Reporting Location
This return must be filed for the reporting period indicated even if you have no taxable purchases to report.
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I do not have cumulative taxable purchases totaling more than $2,000 this calendar year and do not owe consumer’s use tax at this time.
Business Location
Code
Amount of Taxable Purchases
Rate (%)
Amount of Tax
Page 1 Totals .............................................................................
Page
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Totals ............................................................
Totals (All Pages) .......................................................................
1.
2.
Add: Interest for late payments
Instructions are updated annually and are provided on our website
(See Line 2 of Instructions) ............
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at dor.mo.gov/forms/.
3.
Final Return: If this is your final return, enter the close date below and
Add: Additions to tax .........................
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check the reason for closing your account. Missouri law requires any person
4.
selling or discontinuing business to make a final use tax return within fifteen
Subtract: Approved Credit .............
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(15) days of the sale or closing.
Pay this amount
Date Business Closed: ___ ___ / ___ ___ / ___ ___ ___ ___
(U.S.Funds only) ..........................
5.
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Out of Business
Sold Business
Leased Business
Office Use Only
Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct. I have direct control,
supervision, or responsibility for filing this return and payment of the tax due.
Taxpayer or Authorized Agent’s Signature
Title
Date (MM/DD/YYYY)
__ __ /__ __ /__ __ __ __
Printed Name
Tax Period (MM/DD/YYYY) though (MM/DD/YYYY)
__ __ /__ __ /__ __ __ __
through
__ __ /__ __ /__ __ __ __
Form 53-C (Revised 01-2017)
Mail to:
Taxation Division
Phone: (573) 751-2836
Visit
P.O. Box 840
TTY: (800) 735-2966
for additional information.
Jefferson City, MO 65105-0840
Fax: (573) 751-7273
E-mail:
salesuse@dor.mo.gov
Visit
dor.mo.gov/business/creditinquiry
to determine if you have a credit for which you may be entitled to a refund.
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