Form Ref-620 - Application For Refund Of Vt Sales And Use Tax Or Meals And Rooms Tax
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1Vermont Department of Taxes
PO Box 547 Montpelier, VT 05601-0547
*166201100*
Phone: (802) 828-2551
Application for Refund of
* 1 6 6 2 0 1 1 0 0 *
VT Form
VT Sales and Use Tax or
REF-620
Meals and Rooms Tax
Business Name
Telephone Number
Address
Vermont Business Account Number
City
State
ZIP Code
Period Covered by Claim (mm/dd/yyyy - mm/dd/yyyy)
Foreign Country (if not United States)
E-mail Address
Name of Representative (if any)
Telephone Number
Address
City
State
ZIP Code
E-mail Address
Refund Amount . . . . . . .$ __________________ .____
Give a full explanation below (see instructions). Use additional sheets if necessary and submit all documents needed to properly substantiate your claim.
I, the claimant named above, or partner, officer, or other authorized representative of such claimant, make application for refund of Sales and Use tax or Meals and
Rooms tax pursuant to 32 V.S.A. § 9781 (SU), and § 9245 (MR). I certify all Vermont Sales and Use taxes or Meals and Rooms taxes for which this claim is filed, have
been paid, and no portion of the tax has been refunded or credited to me by any vendor.
Signature of Responsible Officer
Date
Daytime telephone
May the Dept. of Taxes discuss this
number (optional)
return with the preparer shown?
(
)
Yes
No
Printed name
E-mail address (optional)
Date
Preparer’s
Check if self-employed
signature
Paid
Preparer’s
Preparer’s Social
Security No. or PTIN
printed name
Preparer’s
Firm’s name (or yours if self-employed) and address
Use Only
EIN
Preparer’s Telephone Number
Preparer’s e-mail address (optional)
(
)
Form REF-620
(formerly SMWA-1)
5454
Rev. 04/16
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