Application For Credit Or Refund Of State And Local Sales Or Use Tax Form

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13-9
Revised 2001
Oklahoma Tax Commission
Account Maintenance Division-AMC
Post Office Box 53248
Oklahoma City, OK 73152-3248
Application for Credit or Refund of State and Local Sales or Use Tax
Type or Print
Name of claimant
Federal I.D. or SSN
Permit number
or Account number
(if registered vendor)
Street address
Telephone Number
Period covered by claim:
City
State
ZIP
Refunds claimed:
Name of representative (provide Power of Attorney)
Credit claimed:
Street address
Telephone Number
If Credit shown above has already been claimed on
City
State
ZIP
Give a full explanation below, including all facts on which your claim is based. Use additional sheets if necessary and submit all
documents necessary to properly substantiate your claim.You may contact the credit/refund section at (405) 521-3270.
IMPORTANT: Refund claims without supporting documents cannot be approved. See the instructions on the back
of this form for details regarding necessary documentation.
I, _____________________________, the claimant named above, or partner, officer, or other authorized representative of such claimant do hereby
make application for a refund and/or credit of sales or use tax, pursuant to Title 68, Section 227 of the Oklahoma Tax Code, and certify that all sales
and use taxes, for which this claim is filed, have been remitted to the Oklahoma Tax Commission, and that this claim does not include any items for
which refund or credit was previously received.
Signature
Title
Date
See instructions on the back of this form

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