Form 53-1 - Sales Tax Return - 2013
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MISSOURI TAX I.D. NUMBER
FEDERAL I.D. NUMBER
FORM
M ISSOURI DEPARTMENT OF REVENUE
RETE
RETE
________________
__________________
TAXATION DIVISION
53-1
P.O. BOX 840
• DONOTWRITEINSHADEDAREAS
JEFFERSON CITY, MO 65105-0840
(573) 751-2836
CLICK HERE
SALESTAXRETURN
TDD(800)735-2966
(REV. 03-2013)
CheckboxifAmendedReturn
OrAdditionalReturn
for instructions to complete this form.
OWNER’S NAME
REPORTING PERIOD
ADDRESS CORRECTION
MAILING ADDRESS
BUSINESS LOCATION
BUSINESS NAME
BUSINESS PHONE NUMBER:
Check here if
phone # changed
(__ __ __) __ __ __ - __ __ __ __
MAILING ADDRESS
TELEPHONE NUMBER
DUEDATE:
CITY
STATE
ZIP
__________
IMPORTANT:
THISRETURNMUSTBEFILEDFORTHEREPORTINGPERIODINDICATEDEVENTHOUGHYOUHAVENOGROSSRECEIPTS/TAXTOREPORT.
ADJUSTMENTS
BUSINESSLOCATION
CODE
GROSSRECEIPTS
TAXABLESALES
RATE(%)
AMOUNTOFTAX
(INDICATE+OR—)
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-
-
-
-
-
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-
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PAGE1TOTALS . ................................
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PAGE TOTALS.................................
-
1.
TOTALS(ALLPAGES).........................
-
You can now file your sales tax return electronically. Visit
2.
SUBTRACT: 2% TIMELY PAYMENT
https://dors.mo.gov/tax/busefile/login.jsp.
–
ALLOWANCE (if Applicable) ...............
FINALRETURN: If this is your final return, enter the close date below and check the reason for
3.
closing your account. Missouri law requires any person selling or discontinuing business to make
=
TOTAL SALES TAX DUE ....................
a final sales tax return within fifteen (15) days of the sale or closing.
4.
Date Business Closed: ___________________________
ADD: INTEREST FOR LATE
+
PAYMENT (See Line 4 of Instructions)
Out of Business
Sold Business
Leased Business
5.
If you pay by check, you authorize the Department of Revenue to process the check electronically.
+
ADD: ADDITIONS TO TAX .................
Any check returned unpaid may be presented again electronically.
6.
SIGNANDDATERETURN: This must be signed and dated by the taxpayer or by the taxpayer’s authorized
–
SUBTRACT: APPROVED CREDIT .....
agent. Mail to: Missouri Department of Revenue, P.O. Box 840, Jefferson City, MO 65105-0840.
7.
PAY THIS AMOUNT ......................
=
I have direct control, supervision, or responsibility for filing this return and payment of the tax due.
(U.S. Funds Only)
Under penalties of perjury, I declare that this is a true, accurate, and complete return.
IATTESTTHATIHAVENOGROSSRECEIPTSTOREPORTFORLOCATIONSLEFTBLANK.
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.
SIGNATURE OF TAXPAYER OR AGENT
TITLE
DATE SIGNED(MM/DD/YYYY)
TAX PERIOD (MM/DD/YYYY) THRU (MM/DD/YYYY)
__ __ / __ __ / __ __ __ __ THRU __ __ / __ __ / __ __ __ __
______/______/____________
DOR 53-1 (03-2013)
For more information, visit
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