Application For Sales/use Tax Refund Form - Ohio Department Of Taxation Page 3

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ST AR

Rev. 8/13

Schedule of Supporting Documents

List every invoice included on the application for refund.

Date of

Amount of

Detailed Statement of Usage

County No.

Name and Address of

Item Sold/

Invoice

Amount

Sale/

Sale/Purchase

Where Tax

(Note: A statutory reason

Period

Purchaser or Supplier

Purchased

Number

of Tax

Purchase

Subject to Tax

Was Remitted

will not sufﬁ ce.)

*A CD-ROM or other portable electronic media containing a Microsoft Excel spreadsheet is required for all claims containing 25 or more invoices. To expedite

the refund process, a CD-ROM or other portable electronic media may also be supplied for those claims containing less than 25 invoices, but it is not required.

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