Form Cr-1 Generic - Application For Refund Of Costs Or Charges For Cash Register Modifi Cations Required For Proper Collection Of County Or Transit Sales Tax

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COUNTY USE ONLY
Account No.
County
Rev. 3/04
County File No.
Application for Refund of Costs or Charges
for Cash Register Modifi cations Required for
Tax Rate Change Date
Proper Collection of County or Transit Sales Tax
1. Name
Print name as shown on Vendor’s License Certifi cate or name of taxpayer
2. DBA
3. Mailing address
Street
City
State
ZIP code
4. Federal employer identifi cation number
Federal Employer Identifi cation No.
Social Security Number
OR Social Security number
5. This application is fi led for the sales tax rate change on
Effective date
0.00
6. Total amount of claim from column (F) on reverse side $
I declare under penalties of perjury that this return or claim (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 and report.
By
Title
Claimant
Date
Instructions
If your business is located in a county or regional transit
Amount to be refunded: If your claim is approved, for
authority that imposes or increases its tax rate, you may be
each location you will receive the lesser of: the actual cost
entitled to reimbursement of all or a portion of the charges or
for reprogramming or $100 for one cash register or $50 per
costs you incurred in reprogramming your cash register(s).
register if you have more than one.
This refund process is not applicable to state sales tax rate
Supporting documents: You must attach copies of invoices
changes – only county/regional transit authorities.
or other documents demonstrating labor and/or material costs
Qualifying cash registers: Are those that you used to
incurred to reprogram your cash registers. All invoices or
compute the correct tax on the date the new tax or increased
other documents must indicate the number of cash registers
tax took effect and that could not have been used to compute
reprogrammed.
the tax correctly unless the adjustments or modifi cations had
Failure to provide any information requested on this
been made.
application or to maintain complete records in support of the
When to fi le: You must fi le within six (6) months of the tax
claim will constitute just grounds for denial of the claim. This
rate increase.
claim must be fi led in accordance with Ohio Revised Code
Section 5739.212.
More than one (1) cash register or more than (1) location:
You may fi le a claim covering more than one location of the
Once you have completed this application,
same business entity and/or more than one cash register
please mail it to your local county auditor.
provided they are in the same county. If you have locations
in different counties, separate claims must be fi led for each
county.
Copy to be retained by applicant.

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