Form 0405-021 - Assignment Of Rights Of Shared Tax Or Fee Payment Page 2
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2Assignment of Rights of Shared Tax or Fee Payment
Instructions
This Assignment of Rights (AOR) form allows local governments to assign all or part of the payment related to a shared
tax or fee program administered by the Tax Division to an Alaska State Agency.
For your protection, the Tax Division will not accept an AOR form with any changes or corrections on the form. This means
that nothing may be crossed out, whited out, or changed and initialed.
The Assignor must hold the position of Mayor, Manager or Administrator of the local government.
The Assignee must be an Alaska State Agency and the assignment must be for a debt owed to that state agency.
Payments cannot be assigned to non-state entities or to an individual.
This form must be complete and be received by the due date identified below to be accepted. Incomplete forms will be
returned to the Assignor. Due dates vary by Tax Share Program.
Tax Share Program
Due Date
Aviation Motor Fuel Tax
June 30
Commercial Passenger Vessel Excise Tax
December 31
Electric/Telephone Cooperative Tax
June 30
Fisheries Business Tax
June 30
Fishery Resource Landing Tax
June 30
Liquor License Fees
June 30 and December 31
A separate form must be completed for each tax share program and each agency to which a shared tax or fee is
assigned.
Once an assignment has been submitted to the Tax Division, it may only be changed or revoked by contacting the Tax
Division at (907) 465-3776. Changes and revocations may only be made prior to the actual date of revenue sharing.
Photocopies will not be accepted.
If you have any questions regarding this form or the AOR process, please contact the Tax Division at (907) 465-3776.
Please send the completed form to: ALASKA DEPARTMENT OF REVENUE
TAX DIVISION
PO BOX 110420
JUNEAU AK 99811-0420
0405-021i New 01/11
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