Form St-9-Am - Amended Sales And Use Tax Return - Massachusetts Department Of Revenue
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1
2ST-9-AM
MASSACHUSETTS DEPARTMENT OF REVENUE
AS
AMENDED SALES AND USE TAX RETURN
PRINT AMOUNTS FROM COLUMN C ON BACK
FEDERAL IDENTIFICATION NUMBER
CHECK BOX IF
TAX PERIOD
A DEPOSITORY FILER
1. GROSS SALES
2. TOTAL DEDUCTIONS
BUSINESS NAME
IF NOT
CORRECT,
3. TAXABLE SALES
PLEASE
BUSINESS ADDRESS
(SUBTRACT LINE 2 FROM LINE 1)
PRINT
CHANGES
4. USE TAX PURCHASES
CITY/TOWN
STATE
ZIP
HERE.
If name, address, identification numbers are incorrect, please check box
and print
5. TOTAL TAXABLE AMOUNT
correct information.
(ADD LINE 3 AND LINE 4)
6. TOTAL TAX
7. PENALTY
Make check payable to Commonwealth of Massachusetts. Return this completed form with payment. Mail to:
8. INTEREST
Massachusetts Department of Revenue, PO Box 7039, Boston, MA 02204-7039.
I declare under the penalties of perjury that this return (including any accompanying schedules and statements)
has been examined by me and to the best of my knowledge and belief is a true, correct and complete return.
9. TOTAL AMOUNT DUE
Signature
Title
Date
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