Form Tr-685 - Sales And Compensating Use Tax Promptax Request For Hardship Exemption
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2TR-685 (6/02)
Sales and Compensating Use Tax
(formerly PR-685)
PrompTax
Request for Hardship Exemption
Vendor ID number
Date
Vendor name
Vendor address
Primary contact name
Primary contact telephone number
Fax number
The purpose of the hardship exemption is to provide relief for vendors who have experienced a significant decrease in
recent tax liability. A separate exemption form must be submitted for each applicable tax type.
You must complete the following worksheet in its entirety and meet the stated criteria in order to qualify for hardship
exemption. Read the instructions on the back of this form before completing it.
Period
Tax amount
(MM/YY – MM/YY)
a Total sales tax — most recently completed quarter. You must
attach a copy of the corresponding ST-810 ......................
a
b Total sales tax — same quarter as line a, prior year .................
b
c Total sales tax — quarter prior to most recently completed quarter ....
c
d Total sales tax — same quarter as line c, prior year ..................
d
e Total sales tax lines
..................................
e
(add line a and line c)
f Total sales tax lines
..................................
f
(add line b and line d)
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2
Calculation
g
(divide line e by line f) ......................................
g
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2
h Total sales tax for two quarters previous to two most current
quarters (the two quarters prior to quarter reported on line c) ....
h
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2
i Calculation
............................................
i
(multiply line h by line g)
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2
Total of lines
j
(add line e and line i) .....................................
j
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2
Check the box next to each exemption criterion that is a correct statement based on the calculations above:
Line g amount is less than .50
Line j is less than $250,000
Line g percentage calculation must be less than .50 and line j must be less than $250,000 to qualify for hardship
exemption.
You will receive notification granting or denying exemption status within 14 calendar days of receipt of your request. If a
hardship exemption is granted, you will be released from participating in the Electronic Funds Transfer
program for
(EFT)
the remainder of this program year and for the subsequent program year. The program cycle ends August 31 of each year.
Certification
I certify that the information shown on this form is to the best of my knowledge and belief true, correct, and complete.
Authorized signature:
Name of signatory:
(please print)
Date:
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