Application For Sales/use Tax Refund Form - Ohio Department Of Taxation
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ST AR
For State Use Only
Rev. 8/13
Overrides: Name Y
N
Address Y
N
Sales and Use Tax Division
Bankruptcy
Cubs
R625
P.O. Box 530
Columbus, OH 43216-0530
Click here
tax.ohio.gov
to print a
Application for Sales/Use Tax Refund
blank form
Consumer
Vendor
The following information refers to the person/entity submitting the application for refund of tax claimed to have been
erroneously paid to the state of Ohio/Clerk of Courts.
Please type or print clearly.
1. Sales or use tax vendor’s license or account number
2. Time period covered by the refund request
to
3. Name of applicant
If business, print name as registered with the Internal Revenue Service
4. Mailing address
Street
City
State
ZIP code
5. a) Federal employer identifi cation number
b) Social Security number
6. Only one amount should be included in this section.
a) Erroneous payment made to vendor
$
b) Erroneous payment made on tax return or voluntary payment
$
c) Erroneous payment made on sales or use tax assessment and/or
case #
$
d) Erroneous payment made to the Clerk of Courts (supporting schedule
and all documentation requested on the form must also be included; see
page 5).
$
7. State basis for claiming refund
8. If a vendor-fi led claim, do you wish to have your approved refund amount moved as a credit to a future period?
Note: Statutory interest is paid when a refund is granted under Ohio Revised Code 5739.07. Statutory interest on credits
moved to a future period is not granted under the Ohio Revised Code.
Yes, move my credit to a future period (indicate dates):
I understand that interest will not be
granted.
(If a confi rmation is not received on or before the due date of the tax return period you requested, contact the sales and
use tax refund unit at 888-405-4039 prior to taking the credit in that period.)
(Please continue to page 3.)
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