Form 4438 - Residential Utility Exemption Certificate
Download a blank fillable Form 4438 - Residential Utility Exemption Certificate 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 4438 - Residential Utility Exemption Certificate 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
2Reset Form
Print Form
FORM
This form is to be given
MISSOURI DEPARTMENT OF REVENUE
4438
TAXATION
to the utility company.
RESIDENTIAL UTILITY EXEMPTION CERTIFICATE
(REV. 11-2007)
NAME
ADDRESS
CITY
STATE
ZIP CODE
___ ___ ___ ___ ___
The following is a list of the residential apartments and/or condominiums owned by the above as they are registered with the utility company and the
percentage of utility services purchased for domestic usage.
I certify if any utility service purchased and declared to be for domestic use is used or consumed by the above for any purpose other than domestic
use, or if the city/county has reimposed local use tax on utilities purchased for domestic use, the above will pay the appropriate tax due directly to the
proper taxing authority when state law so provides or inform the seller for additional billing. I also declare under penalties of perjury that I employ no
illegal or unauthorized aliens as defined under federal law and that I am not eligible for any tax exemption, credit or abatement if I employ such aliens.
I swear or affirm the information on this form is true and correct as to every material matter.
AUTHORIZED SIGNATURE (OWNER, PARTNER OR CORPORATE)
DATE
__ __ / __ __ / __ __ __ __
This publication is available upon request in alternative accessible format(s).
MO 860-2608 (11-2007)
FORM
This form is to be given
MISSOURI DEPARTMENT OF REVENUE
4438
TAXATION
to the utility company.
RESIDENTIAL UTILITY EXEMPTION CERTIFICATE
(REV. 11-2007)
NAME
ADDRESS
CITY
STATE
ZIP CODE
___ ___ ___ ___ ___
The following is a list of the residential apartments and/or condominiums owned by the above as they are registered with the utility company and the
percentage of utility services purchased for domestic usage.
I certify if any utility service purchased and declared to be for domestic use is used or consumed by the above for any purpose other than domestic
use, or if the city/county has reimposed local use tax on utilities purchased for domestic use, the above will pay the appropriate tax due directly to the
proper taxing authority when state law so provides or inform the seller for additional billing. I also declare under penalties of perjury that I employ no
illegal or unauthorized aliens as defined under federal law and that I am not eligible for any tax exemption, credit or abatement if I employ such aliens.
I swear or affirm the information on this form is true and correct as to every material matter.
AUTHORIZED SIGNATURE (OWNER, PARTNER OR CORPORATE)
DATE
__ __ / __ __ / __ __ __ __
This publication is available upon request in alternative accessible format(s).
MO 860-2608 (11-2007)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial