Form 4783 - Consumer Payment Voucher Page 2
Download a blank fillable Form 4783 - Consumer Payment Voucher 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 4783 - Consumer Payment Voucher 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
1
2Consumer Payment Voucher
Instructions
When is a Consumer Payment Voucher to Be Used?
Use a consumer payment voucher when the consumer has purchased tax-exempt fuel and used it for a taxable purpose or when the
consumer knows that the fuel tax was not precollected.
When is the Payment Due?
The payment of taxes will be due on the last day of the month for any purchases made in the preceding calendar month.
Completing the Voucher
General Information:
Complete each line on the top portion of the voucher. Be sure to include all information requested.
Round to whole gallons and whole dollars.
Listing Purchase Information:
Provide all requested information for all gallons purchased tax-exempt and used for a taxable purpose.
Calculating Tax (Line 2):
Multiply the total taxable gallons (Line 1) (x) $0.17 to calculate the tax due.
Penalty (Line 3):
Calculate any penalty due by multiplying the total tax due (Line 2) by 5 percent per month up to 25 percent of the total tax due.
Interest (Line 4):
Calculate any interest due by multiplying the total tax due (Line 2) by the annual interest rate. Divide this number by 365 (366 in a leap
year) and multiply the result by the number of days payment is late. The annual interest rate is subject to change each year. You may
access the annual interest rate on the Department’s web site at
Total Paid (Line 5):
Add Lines 2, 3, and 4 for the total paid on voucher.
Mailing the Voucher and Remittance:
Send your check or money order to the Missouri Department of Revenue, Taxation Division, Excise Tax, P.O. Box 300, Jefferson City,
MO 65105-0300. You may also charge the balance due to Mastercard, Discover, American Express, or Visa by calling toll-free
(888) 929-0513 or you may pay online at A convenience fee will be charged to your
account for processing. If you pay by check, you authorize the Department to process the check electronically. Any returned check may
be presented again electronically.
If you have questions or need assistance in completing this form, please call (573) 751-2611 or e-mail excise@dor.mo.gov. You may
also access the Department’s web site at to obtain this form.
(10-2011)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial