Form 332 - Cash Bond
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Missouri_Department_of_Revenue
Form
332
Cash Bond
Personal_or_company_checks_will_not_be_accepted_as_payment.__Please_remit_a_cashiers_check_or_money_order.
Select_only_one:
r
r
Sales_and_Use_Tax_
_
Motor_Fuel_Tax
r
Other_Tobacco_Products__
_
_ Motor_Fuel_license_type_(Select_One):_
r
Cigarette_Tax_
_
_
r
r
_
__ S upplier_or_Permissive_Supplier_ _
Distributor
r
r
r
Transient_Employer_Withholding_and_Unemployment_Tax
Terminal_Operator_
_Transporter
Amount_(U.S._Currency_-_No_personal_or_company_checks)
Date_(MM/DD/YYYY)
_ _
$
______/_______/____________
At_the_request_of_Taxpayers_or_Business_(Owner’s_name,_all_Partners,_Corporation,_or_LLC_Name)
Taxpayer_or_Business_Owner’s_Address_
City
_
_
County
State__
Zip_Code_
E-mail_Address
_
_ _ _______________________________________________________________(Taxpayer)_hereby_files_with_the_Missouri_
Department_of_Revenue_(Department)_this_cash_bond_and_the_attached_cashier’s_check_or_money_order_in_the_amount_of_
______________________________________________________________________($________________________).
Taxpayer_understands_that_it_is_required_to_comply_with_all_the_provisions_of_any_statutorily_or_constitutionally_authorized_state_
or_local_tax.
If_Taxpayer_becomes_delinquent_and_owes_the_Department_the_above_indicated_tax,_related_fees,_interest,_additions_to_tax,_ _
and_ penalties_ due_ the_ state_ of_ Missouri,_ the_ Director_ of_ Revenue_ may_ forfeit_ this_ bond_ and_ apply_ it_ to_ any_ unpaid_ _
delinquencies.
Delivery_ of_ any_ demands,_ notice,_ or_ service_ of_ process_ by_ the_ Department_ shall_ be_ deemed_ sufficient_ and_ made_ in_ the_
state_ of_ Missouri_ if_ personally_ served_ or_ if_ mailed_ by_ U.S._ mail_ to_ the_ taxpayer_ or_ business_ address_ as_ set_ forth_ above._ _
This_cash_bond_and_any_legal_action_pertaining_thereto_shall_be_governed_by_and_construed_in_accordance_with_the_laws_of_
the_state_of_Missouri.__The_parties_understand_and_agree_that_the_exclusive_jurisdiction_for_any_action_concerning_this_bond_
shall_be_the_state_of_Missouri_and_the_only_venue_shall_be_in_the_Circuit_Court_of_Cole_County,_Missouri.
By_signing_this_cash_bond,_the_undersigned_states_that_he_or_she_has_authority_to_bind_the_taxpayer_or_business_identified_
herein.
No digital signatures allowed
Owner,_Partner,_Corporate_Officer_or_LLC_Member_
Date_(MM/DD/YYYY)
______/_______/____________
Form_332_(Revised_07-2013)
Mail to:
Sales_and_Use_or_Transient_Employer__
Withholding_
Motor_Fuel_Tax_
Cigarette_Tax_
Other_Tobacco_Products_
Taxation_Division_
Taxation_Division_
Taxation_Division_
Taxation_Division
P.O._Box_357_
P.O._Box_300_
P.O._Box_811_
P.O._Box_3320
Jefferson_City,_MO__65105-0357_
Jefferson_City_MO_65105-0300_
Jefferson_City_MO_65105-0811_
Jefferson_City,_MO_65105-3320
Phone:__(573)_751-5860_
Phone:__(573)_751-2611_
Phone:__(573)_751-7163_
Phone:__(573)_751-5772
Fax:__(573)_522-1722_
Fax:_(573)_522-1720_
Fax:__(573)_522-1720_
Fax:__(573)_522-1720
E-mail:__businesstaxregister@dor.mo.gov_
E-mail:__excise@dor.mo.gov_
E-mail: excise@dor.mo.gov_
E-mail:__excise@dor.mo.gov
Visit_ (800)_735-2966
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