Form 51a602 - Expenditure Report For Building Materials Disaster Relief Refunds

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EXPENDITURE REPORT FOR BUILDING MATERIALS
51A602 (4-12)
DISASTER RELIEF REFUNDS
Commonwealth of Kentucky
1. Include only one Contractor/Sub-contractor (Purchaser) per page.
DEPARTMENT OF REVENUE
2. Please total costs by Vendor.
3. Provide copies of invoices from each Vendor as samples.
Disaster Area County
Construction
Address
Name of Legal Building Owner:
Contractor/Sub-Contractor Name:
Contractor/Sub-Contractor SU Tax Account # (if applicable):
6
7
8
1
2
3
4
5
Vendor Name
Invoice #
Date of
Period Tax
General description of building materials
Total Cost
KY SU Tax
Total by Vendor
Paid
Invoice
Reported
purchased
An Equal Opportunity Employer M/F/D

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