Form 3069 - Sales Tax Direct Pay Return
ADVERTISEMENT
1DLN
MISSOURI DEPARTMENT OF REVENUE
FORM
DIVISION OF TAXATION AND COLLECTION
3069
P.O. BOX 840 JEFFERSON CITY, MO 65105-0840
(573) 751-2836
TDD (800) 735-2966
(REV. 12-99)
SALES TAX DIRECT PAY RETURN
ACCOUNT NUMBER
PERIOD
OWNER’S NAME
BUSINESS NAME
MAILING ADDRESS
TELEPHONE NUMBER
(
)
CITY
STATE
ZIP CODE
(DO NOT WRITE IN SHADED AREAS)
TAXABLE
BUSINESS LOCATION
CODE
RATE
AMOUNT OF TAX
PURCHASES
1.
TOTAL
2.
2. SUBTRACT 2% TIMELY PAYMENT
–
ALLOWANCE (If applicable) . . . . . . . . .
3.
3. TOTAL SALES TAX DUE . . . . . . . . . . .
4.
4. ADD: INTEREST FOR LATE
–
PAYMENT . . . . . . . . . . . . . . . . . . . . . . .
5.
5. ADD: ADDITIONS TO TAX . . . . . . . . . .
+
6.
6. PAY THIS AMOUNT . . . . . . . . . . . . . . .
=
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of
my knowledge and belief it is true, correct and complete. RETURN MUST BE SIGNED AND DATED.
SIGNATURE OF TAXPAYER OR AGENT
TITLE
TAX PERIOD (MMDDCCYY) THRU (MMDDCCYY)
DATE
This publication is available upon request in alternative accessible format(s).
MO 860-2182 (12-99)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial