Form E-585e - State Agency Claim For Refund County Sales And Use Taxes
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1
2State Agency Claim for Refund
E-585E
Web
County Sales and Use Taxes
7-11
North Carolina Department of Revenue
Complete all of the information in this section.
State Agency Name (First 32 Characters) (USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
Account ID
Mailing Address
Federal Employer ID Number
Interoffice or Courier Mailing Address
Quarter Beginning (MM-DD-YY)
City
State
Zip Code
County
Quarter Ending (MM-DD-YY)
Name of Person We Should Contact if We Have Questions About This Claim
Contact Telephone
(
)
1.
Name of Taxing County
(If more than one county, see instructions on reverse and attach Form E-536R)
County
.
,
,
2.
Amount of County Sales and Use Tax Paid Indirectly on Building Materials and
Supplies as Shown on Contractors’ Statements
3.
Allocation of County Tax on Line 2 (Enter the county tax paid at each applicable rate. If you paid more than one county’s tax, see the
instructions on reverse and attach Form E-536R)
Mecklenburg
County 2.0% Tax
County 2.25% Tax
Transit 0.5% Tax
,
,
.
,
,
.
,
.
Signature:
Date:
I certify that, to the best of my knowledge, this claim is accurate and complete.
Title:
Telephone:
MAIL TO: NC Department of Revenue, P.O. Box 25000, Raleigh, NC 27640-0001
For Departmental Use Only
Refund Approved:
County Tax
As Filed
By:
,
,
.
As Corrected
Date:
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Parent category: Financial