Form 5359 - Excess Traffic Violations
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MISSOURI DEPARTMENT OF REVENUE
COUNTY TAX SECTION
FORM
PO BOX 453
5359
JEFFERSON CITY MO 65105-0453
(573) 751-5858
EXCESS TRAFFIC VIOLATIONS
REV. (10-2011)
GENERAL INSTRUCTIONS:
Under Section 302.341, RSMo, if any city, town, or village obtains more than 35 percent of its
annual operating general revenue from fines and court costs from traffic violations occurring on state
highways, the city, town, or village must send the excess amount to the Director of the Department of
Revenue.
For purposes of Section 302.341, RSMo, a “state highway” is any state or federal highway, including any
highway that continues through the boundaries of the city, town, or village with a designated street name
other than the state highway number.
CITY NAME
COUNTY NAME
CHECK NUMBER
CHECK AMOUNT
REPORTING PERIOD
SIGNATURE
DATE
__ __ / __ __ / __ __ __ __
DOR-5359 (10-2011)
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