Application Fabricators Sales & Use Tax Refund For Contractors And Subcontractors - South Dakota Department Of Revenue - 2005 Page 2

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SD EForm -
V1
1917
Complete and use the button at the end to print for mailing.
HELP
Application Fabricators Sales & Use Tax Refund for Contractors and Subcontractors
Claim Amount - Include SD state sales or use tax only, do not include municipal tax: __________________________________________________________
Credit -
This is a request for a:
Approved credit will be applied to your account for use on future returns. This information will be added as a
credit on the contractors’ excise tax return corresponding to the date of this application. Do not use the credit
until you receive written notice that the claim has been approved.
Refund -
A check will be mailed after the claim is approved.
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The undersigned declare and affirm under the penalties of perjury that they have examined the information contained in the above application and all such
information is, in all things, true and correct.
Dated this ____________________ day of ____________________________________, 20_______.
Signature _________________________________________________________________________Title __________________________________________
Mail completed application and attachments to: SD Department of Revenue, 445 East Capitol Avenue, Pierre, SD 57501
PRINT FOR MAILING
CLEAR FORM

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