Fillable Form 8a - Affidavit For Bad Debt Loss

Form 8a - Affidavit For Bad Debt Loss - 2014

Download a blank fillable Form 8a - Affidavit For Bad Debt Loss - 2014 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 8a - Affidavit For Bad Debt Loss - 2014 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Reset Form

Print Form

Document Locator Number (Department Use Only)

Form

Missouri Department of Revenue

Affidavit for Bad Debt Loss

Name

License Number

Federal Employer Identification Number (FEIN)

Month and Year

__ __ / __ __ __ __

Address

P.O. Box

City

State

ZIP Code

Telephone Number

(__ __ __) __ __ __ - __ __ __ __

Attach copies of all documents identified below. Supplier credit is limited to the amount due from the purchaser and any amount accruing for a period not to exceed ten days

or the date of notification to the director, whichever is earlier following the date of failure to make payment. Round to whole dollars.

Eligible Purchaser

Document

Selling Date

Gallons

Product

Tax or Fee Rate

Eligible Purchaser’s Name

Total Amount Claimed

License Number

Number

(MM/DD/YYYY)