Form 4854 - Employer Withholding Tax Refund Request
Download a blank fillable Form 4854 - Employer Withholding Tax Refund Request 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 4854 - Employer Withholding Tax Refund Request 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.
ADVERTISEMENT
1Reset Form
Print Form
Form
Missouri Department of Revenue
4854
Employer Withholding Tax Refund Request
You must receive confirmation from the Department of Revenue that a valid overpayment exists prior to completing this form.
Missouri Tax Identification Number
Tax Period (YYYY/MM)
Overpay Amount
____ ____ ____ ____ / ____ ____
|
|
|
|
|
|
|
Federal Employer Identification Number (FEIN)
Telephone Number
Department Use Only
(
)
-
____ ____ ____
____ ____ ____
____ ____ ____ ____
|
|
|
|
|
|
|
|
|
|
|
|
|
Business Name
Business Address
City
State
Zip Code
Provide a detailed description of the reason for overpayment. (Required)
Signature (Required)
Date (MM/DD/YYYY)
___ ___ / ___ ___ / ___ ___ ___ ___
Form 4854 (Revised 05-2014)
Mail to:
Taxation Division
Phone: (573) 751-7200
Visit
P.O. Box 3375
Fax: (573) 522-6816
for additional information.
Jefferson City, MO 65105-3375
E-mail:
withholding@dor.mo.gov
Form
Missouri Department of Revenue
4854
Employer Withholding Tax Refund Request
You must receive confirmation from the Department of Revenue that a valid overpayment exists prior to completing this form.
Missouri Tax Identification Number
Tax Period (YYYY/MM)
Overpay Amount
____ ____ ____ ____ / ____ ____
|
|
|
|
|
|
|
Federal Employer Identification Number (FEIN)
Telephone Number
Department Use Only
(
)
-
____ ____ ____
____ ____ ____
____ ____ ____ ____
|
|
|
|
|
|
|
|
|
|
|
|
|
Business Name
Business Address
City
State
Zip Code
Provide a detailed description of the reason for overpayment. (Required)
Signature (Required)
Date (MM/DD/YYYY)
___ ___ / ___ ___ / ___ ___ ___ ___
Form 4854 (Revised 05-2014)
Mail to:
Taxation Division
Phone: (573) 751-7200
Visit
P.O. Box 3375
Fax: (573) 522-6816
for additional information.
Jefferson City, MO 65105-3375
E-mail:
withholding@dor.mo.gov
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial