Form 163 - Sales Tax Protest Payment Affidavit
Download a blank fillable Form 163 - Sales Tax Protest Payment Affidavit in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 163 - Sales Tax Protest Payment Affidavit with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4Department Use Only
Form
Missouri Department of Revenue
(MM/DD/YY)
163
Sales Tax Protest Payment Affidavit
Reporting Period
(MM/YY)
Missouri Tax I.D.
Federal Employer
Number
I.D. Number
Case Number
(if applicable)
Owner’s Name
Business Name
Mailing Address
City
State
Zip Code
Phone Number
PPRE
Department Use Only
FPRE
(__ __ __) __ __ __ - __ __ __ __
This form is to be used for filing a sales tax protest payment in compliance with
Section 144.700,
RSMo. Use this form in conjunction with the
Nonprotested Sales Tax Payment Report
(Form
2039) when filing a partial protest payment and use by itself when filing a fully protested payment.
Adjustments
Tax
Business Location
Gross Receipts
Taxable Sales
Tax Type
Amount of Tax
Rate (%)
Indicate + or – )
-
City:
State
3%
-
Conservation
1/8%
-
Education
1%
Location Code:
-
Parks and Soil
1/10%
-
City: __ __ __ __ __
-
County: __ __ __
-
Site: __ __ __ __
-
-
-
-
-
-
-
-
-
Enter total amount of tax from Schedule A (Page 3)
Enter Total Amount Of Tax
1.
Final Return: If this is your final return, enter the close date below and select
Subtract: 2% of Line 1
2.
the reason for closing your account. The Sales Tax law requires any person
only if paid by due date
–
selling or discontinuing business to make a final sales tax return within 15 days
Total amount of tax due:
3.
of the sale or closing.
(Line 1 minus Line 2)
=
__ __ /__ __ /__ __ __ __
Add: Interest for late payment
4.
Date Business Closed (MM/DD/YYYY)
(See Instructions)
+
r Leased Business
r Out of Business r Sold Business
Add: Additions to Tax (5% per month
5.
late of Line 3, maximum 25%)
+
If you pay by check, you authorize the Department of Revenue to process
Remit single check for this
6.
the check electronically. Any check returned unpaid may be presented
amount: (Add Lines 3, 4, 5)
again electronically.
=
Department Use Only
*14008010001*
Form 163 (Revised 12-2014)
14008010001
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial