Form E-585h - Claim For Refund Of White Goods Disposal Tax
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1Claim for Refund of White Goods Disposal Tax
E-585H
Web
North Carolina Department of Revenue
5-07
Legal Name (First 32 Characters)
(USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
Account ID
Trade Name
Federal Employer ID Number
Street Address
Quarter Beginning (MM-DD-YY)
County
City
State
Zip Code
Quarter Ending (MM-DD-YY)
Contact Telephone
Name of Person We Should Contact if We Have Questions About this Claim
(
)
Quantity
Tax
,
,
.
1.
Enter the Number of White Goods Purchased and the
00
Amount of White Goods Disposal Tax Paid
(Attach copies of invoices and purchase orders)
,
$
.
2.
Total Refund Requested (Multiply the Tax on Line 1 by .60)
General Instructions
This claim applies to a person who purchases 50 or more new white goods of any kind in the same purchase and places
all of them in new or remodeled dwelling units that are located in North Carolina and do not contain the kind of white goods
purchased. If you have questions about how to complete this claim for refund, you may call the Taxpayer Assistance Call
Center toll-free at telephone number 1-877-252-3052.
Use blue or black ink to complete this claim for refund.
If you are registered for sales and use tax purposes, enter your sales and use tax registration number in the space
marked “Account ID.” If you are not registered for sales and use tax purposes, enter your Federal Employer Identification
Number in the space marked for that number.
This claim is due quarterly within 60 days after the close of the calendar quarter. Refund claims filed more than 3 years
after the due date cannot be accepted.
Copies of invoices and purchase orders must be submitted with the claim for refund.
Signature:
Date:
I certify that, to the best of my knowledge, this claim is accurate and complete.
Title:
Telephone:
MAIL TO: NC Department of Revenue, P.O. Box 25000, Raleigh, NC 27640-0001
For Departmental Use Only
Refund Approved:
By:
As Filed
,
.
As Corrected
Date:
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