Form 2039 - Nonprotested Sales Tax Payment Report
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Department Use Only
Missouri Department of Revenue
Form
(MM/DD/YY)
2039
Nonprotested Sales Tax Payment Report
Reporting Period
(MM/YY)
Missouri Tax I.D.
Federal Employer
Number
I.D. Number
NPRE
Department Use Only
Owner’s Name
Business Name
Mailing Address
City
State
Zip Code
E-mail Address
Phone Number
(__ __ __) __ __ __ - __ __ __ __
This form is to be used in conjunction with the Sales Tax Protest Payment Affidavit
(Form
163). Any nonprotested sales tax
payments in a reporting period for which you filed a Protest Payment Affidavit must be reported on this form.
Business Location
Adjustments
Tax Type
Tax Rate
Amount of Tax
Gross Receipts
Taxable Sales
(enter below)
Indicate + or -
-
State
3%
-
Conservation
1/8%
-
Education
1%
-
Parks and Soil
1/10%
-
-
-
Reset This Section Only
-
-
-
Enter total amount of tax from all pages
1.
Subtract: 2% of Line 1 only if paid by
2.
Final Return: If this is your final return, enter the close date below and check
due date............................................
–
the reason for closing your account. Missouri law requires any person selling
Total amount of tax due:
3.
or discontinuing business to make a final sales tax return within 15 days of the
(Line 1 minus Line 2) ........................
=
sale or closing.
4.
Add: Interest for late payment
+
(see Instructions) ..............................
__ __ /__ __ /__ __ __ __
Date Business Closed (MM/DD/YYYY)
Add: additions to tax (5% per month
5.
late of Line 3, maximum 25%) ..........
+
r
r
r
Out of Business
Sold Business
Leased Business
Remit single check for this
6.
amount: (add Lines 3, 4, 5)...............
=
If you pay by check, you authorize the Department of Revenue to process the check electronically. Any check returned unpaid may be
presented again electronically.
Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct.
Signature
Title
Printed Name
Date (MM/DD/YYYY)
__ __ /__ __ /__ __ __ __
Form 2039 (Revised 12-2014)
Mail to:
Taxation Division
Phone: (573) 526-9938
Visit
P.O. Box 3350
TTY: (800) 735-2966
for additional information.
Jefferson City, MO 65105-3350
Fax: (573) 751-9409
E-mail:
salesuse@dor.mo.gov
*14017010001*
14017010001
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