TENNESSEE DEPARTMENT OF REVENUE
TIRE PRE-DISPOSAL FEE RETURN
SSN
FEIN
ACCOUNT NO.
WORKSHEET FOR COMPUTING TAX
ROUND TO NEAREST DOLLAR
00
00
00
00
00
00
Keep Upper Portion For Your Records
Return Copy Below - Detach Here
TIR
00
408
00
ACCOUNT NO.
00
00
00
00