Form 4583 - City Fees
Download a blank fillable Form 4583 - City Fees in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 4583 - City Fees with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1Reset Form
Print Form
MISSOURI DEPARTMENT OF REVENUE
FORM
TAXATION DIVISION
4583
P.O. BOX 453
(573) 751-5900
JEFFERSON CITY, MISSOURI 65105-0453
(REV. 11-2007)
CITY FEES
GENERAL INSTRUCTIONS
Please report on a monthly basis. Send your report and payment by the 20th of the month following collection. (Example — all funds
collected in May send by June 20th.)
If you have cases making partial payments, please indicate so on the form, noting “partial payments included”, and report the total number
of cases that have paid in full.
REPORTING PERIOD: FROM
TO
IN THE COURT OF
COUNTY,
CITY, MISSOURI
NO. OF
AMOUNT PER
FEE TYPE
TOTAL AMOUNT
CHECK NUMBER
CASES
CASE
CRIME VICTIM COMPENSATION FUND:
$
$
(95% of $7.50 surcharge — submit one check.)
COURT AUTOMATION FUND FEE:
$
$
($7.00 — submit one check.)
CLERK FEES:
$
(Indicate the total amount due and submit one check.)
EACH FEE TYPE REPRESENTS A DIFFERENT FEE, THEREFORE PLEASE SEND A SEPARATE CHECK FOR EACH FEE.
*NOTE: IF NO ACTIVITY, PLEASE RETURN FORM INDICATING “NO ACTIVITY” IN THE APPROPRIATE BOX.
SIGNATURE
DATE
This form is available upon request in alternative accessible format(s).
MO 860-2693 (11-2007)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial