Refund Petition Form - Alatax
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1
2AlaTax Refund Petition
Mail To:
AlaTax
Attn: Refunds
rd
2317 – 3
Avenue North
revenue discovery systems
Suite 200
Birmingham, AL 35203-3835
Refund Petition
[ ] Joint
[ ] Direct
Note: Separate petitions are required for each type of tax and for each city or
county.
(Instructions on Back)
The undersigned hereby makes application for refund of ($________________)
_____________________________________________Dollars. Taxes paid by said
undersigned to the Tax Trust Account for (city or county) ___________________ for the
period(s) _______________________, which amount was erroneously paid or paid in
excess of the amount due or was paid through mistake of fact or law.
Explain in detail the reasons for refund claim (attach additional pages if necessary):
Signatures:
A joint petition must bear the signatures of both the seller and the
consumer-purchaser. If a petitioner is an individual, the individual must sign. If a
petition is a partnership or limited liability partnership, a partner must sign. If a petition is
a corporation, an officer of the corporation must sign. If a petition is a limited liability
company, a member must sign.
___________________________________________________________
___________________________________________________________
Petitioner’s Name (Consumer-Purchaser)
Petitioner’s Name (Seller)
___________________________________________________________
___________________________________________________________
AlaTax Account #
Telephone #
AlaTax Account #
Telephone #
___________________________________________________________
___________________________________________________________
Petitioner’s Signature/Title
Petitioner’s Signature/Title
___________________________________________________________
___________________________________________________________
Mailing Address
Mailing Address
___________________________________________________________
___________________________________________________________
City
State
Zip
City
State
Zip
______________________
______________________
Date Signed
Date Signed
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