Form St Ar Obs - Application For Compensation Of Expenses Incurred For Origin-Based Sourcing Tax Collections Form - Department Of Taxation Page 2

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ST AR OBS
Dev. 6/09
Page 2
Instructions
1. Lines 1 through 7 on page 1 of this application must be completed. Please type or print in ink.
2. The application must be fi led in duplicate. Please make a copy for your records. Mail to:
Ohio Department of Taxation
Attn: Sales and Use Tax Refund Unit
P.O. Box 530
Columbus, Ohio 43216-0530
3. The following information must be included with this request:
• a numerical list of all active vendors’ licenses for the entity noted on line 4 of page 1 of this application;
• copies of invoice(s) or other documentation refl ecting any expenses incurred to switch to origin-based sourcing;
• copies of canceled checks or other proof that the invoices or other expenses were paid in full;
4. An entity may receive the lesser of $1,000 for vendors that were required by law to convert to destination-based sourcing
prior to April 18, 2008, or $600 for vendors that irrevocably elected to convert to destination-based sourcing prior to that
date, or the actual cost to switch to origin-based tax collections.
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