Total Approved__________________________________
1. Lines 1 through 8 on the front of this application must be completed, if applicable. Please type or print in ink.
2. All lines in section 6 on the front of this application may not contain information. If figures need to be entered on
more than one line, multiple refund applications must be submitted.
3. THE ORIGINAL AND ONE COPY OF THE RT AR MUST BE FILED. Only one set of back-up documents is
needed. Please make a copy of the application for your records. Mail to:
Ohio Department of Taxation
Attn: Sales and Use Tax Compliance Unit
P.O. Box 530
Columbus, OH 43216-0530
4. This application must be filed in accordance with R.C. sections 5739.104 and must be filed within four years
from the date of the erroneous payment of the tax. If you choose to have someone else represent you for this
refund, you must complete section 8 on the front of the application or submit a power of attorney or state of
Ohio form TBOR 1.
5. When a refund is granted under O.R.C. section 5739.104, it shall include interest thereon as provided by R.C.
section 5703.47.
6. In the event that any person/entity entitled to a refund is indebted to the state of Ohio, the amount of such
indebtedness that is due and payable shall be certified to the auditor of state by the tax commissioner, along
with their determination upon the application for refund. A warrant, up to the amount of any indebtedness, shall
be drawn payable to the Ohio Treasurer of State in satisfaction of the amount due the state as authorized in
R.C. sections 5739.072 and 5741.101. Any excess of such indebtedness shall be drawn payable to the
applicant.