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 Page 2

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CR-1 Generic
Worksheet for Computation of Refund Pursuant to O.R.C. Section 5739.212
Rev. 3/04
(A)
(B)
(C)
(D)
(E)
(F)
County, Vendor’s License,
Total Cost or Charge
Total Number of Cash
Cost/Charges per Register
$100 for 1 Register or
Total Refund for This
Business Address
to Reprogram Registers
Registers Reprogrammed
to Reprogram (B)/(C)
$50 Each for 2 or More
Location [Lesser of (B) or (E)]
Total Refund for All Locations in This County – Carry to Line 6 on Opposite Side
0.00

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