Refund Claim: For Sales Tax Paid Form - City And County Of Broomfield
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1City and County of Broomfield
Sales Tax Administration
ONE DESCOMBES DRIVE
BROOMFIELD, CO 80020
303-464-5811
720-294-9825 (fax)
REFUND CLAIM :
FOR SALES TAX PAID
1)
This claim form must be accompanied by supporting documentation of sales tax paid to a
BROOMFIELD
vendor. Include copies of sales invoices , receipts , building_ permits , etc ., or any other documentation that
proves the amount of tax paid.
2)
If this claim is for sales tax paid, where you have previously paid Local Use Tax on a building_ permit, we
will limit the refund to the amount of Use Tax paid and receipted on the permit. We do not refund State or
RTD
sales tax, as those taxes are not "pre-paid" on the building permit.
3)
Claims for local sales tax paid to other jurisdictions will not be accepted . You must file with the other
jurisdictions.
4) This claim form must be signed and dated by the taxpayer. If the taxpayer is a corporation, the claim must
be signed with the corporation name, followed by the signature and title of the officer having the authority
to sign for the corporation. Incomplete forms will not be processed .
1)
Taxpayer Name
2)
Taxpayer DBA (If applicable)
3 )
Mailing Address
4)
5)
6)
City
State
Zip code
8)
9)
Original Amount Paid
Correct Amount
Refund Requested
10) Reason for claim: Supporting documentation must be attached :
11) I declare under penalty of perjury in the second degree that this claim, including all attachments, is true and
correct to the best of my knowledge :
12)
13)
Signature
Date
Signat ure of Preparer
(if other than taxpayer)
14)
15)
Title
Telephone #
Fax #
16)
17)
Name of Firm:
Te lephone #
Fax #
18)
19)
Email address
Date
I
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Parent category: Financial