Form Rv140 - Direct Payment Permit Application - 2001
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1License #_____________________________
DP# ________________________________
Department of Revenue and Regulation
Approved By: ________________________
Direct Payment Permit Application
Date: _______________________________
1. Owner, Partner, or Corporation Name (name of persons/entity owning business): _____________________________________
Mailing Address: ________________________________________________________________________________________
City: ______________________________________________
State: ___________
Zip Code: ___________________
2. Contact Person: ________________________________________________________
Phone: _____________________
3. Business Name: _________________________________________________________________________________________
Business Location: ______________________________________________________________________________________
Sales Tax Permit #: ____________________________________________________________________________________
(If multiple locations, please attach a listing of each location and sales tax permit number for each location)
4. What is the dollar amount of annual purchases subject to sales or use tax? __________________________
5.
Does your accounting system have sufficient internal controls to accrue sales or use tax accurately?
Yes
No
6.
Can your accounting system isolate purchases for your South Dakota registered locations?
Yes
No
7.
Does your accounting system maintain separate general ledger accounts for sales tax collected from customers and for sales or
use tax accrued?
Yes
No
8. Does your accounting system maintain separate general ledger accounts for sales or use tax paid to vendors?
Yes
No
Attach a description of your accounting system.
Certification
•
I am requesting a Direct Payment Permit in order to pay the tax on taxable materials and services directly to the Department of
Revenue and Regulation at the time of taxability, rather than to the vendor at the time of purchase and to include such payments
with the monthly sales and use tax return.
•
I agree to file and pay monthly sales and use tax returns.
•
I agree to file and pay sales and use tax by electronic means.
•
I agree that the above name may be published as a Direct Payment Permit holder on the department’s website and in any other
related publication, and may be disclosed as a Direct Payment Permit holder in any other manner for tax administration
purposes.
This application must be signed
by the business owner, a responsible corporate officer, or authorized person.
I certify that, to the best of my knowledge, this application is accurate and complete.
________________________________________________________________________________________________________________
Signature(s)
Date
1.
PRINT FOR MAILING
2.
EXIT
CLEAR FORM
RV140 12/01
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