Form 573 - Schedule Of Supplier Tax-Paid Receipts Page 2
Download a blank fillable Form 573 - Schedule Of Supplier Tax-Paid Receipts 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 573 - Schedule Of Supplier Tax-Paid Receipts 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
2INSTRUCTIONS FOR SCHEDULE OF SUPPLIER TAX-PAID RECEIPTS
General Instructions
This schedule(s) provides detail in support of the amount(s) shown as tax-paid receipts on Form 572, Supplier/Permissive Supplier’s Monthly Tax Report.
Each receipt of product should be listed on a separate line. Complete a separate schedule for each product type.
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.
Identifying Information
Company Name, License Number and FEIN:
Enter the name and numbers for the supplier shown on the supplier report.
Column Instructions
Columns 1 and 2:
Carrier — Enter the name and FEIN of the company that transports the product.
Column 3:
Mode of Transport — Enter the mode of transport from the terminal. Use one of the following:
J = Truck
R = Rail
B = Barge
PL = Pipeline
BA = Book Adjustment
ST = Stationary Transfer
Column 4:
Point of Origin/Destination — Enter the location the product was transported from/to. When received into or from a terminal, use the IRS Terminal
Control Code.
Columns 5 and 6:
Seller’s Name and FEIN — Enter the name and FEIN of the company the product was acquired from.
Column 7:
Date Shipped — Enter the date the product was received.
Column 8:
Document Number — Enter the identifying number from the document issued at the terminal when product is removed from the rack. In case of
pipeline or barge movements, enter the pipeline or barge ticket number.
Column 9:
Net Gallons — Enter the net amount of gallons received.
Column 10:
Gross Gallons — Enter the gross amount of gallons received.
Column 11:
Invoiced Gallons — Enter the number of gallons billed (should equal either net or gross gallons).
Use these figures to complete the worksheet on reverse side of Form 572, Supplier/Permissive Supplier’s Monthly Tax Report, Line 4A.
MO 860-1110 (02-2011)
DOR-573 (02-2011)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial