Form Rv-140 - Direct Payment Permit Application Page 3
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1
2
3Direct Payment Permit Application
Revised
05/11
South Dakota Department of Revenue
445 E. Capitol Avenue | Pierre, SD 57501-3185 | 1-800-829-9188
RV-140
E-mail: bustax@state.sd.us
1.
Owner, Partnet, or Corporation Name:
South Dakota Sales Tax Permit Number:
Mailing Address:
City:
State:
Zip Code:
2.
Contact Person:
Phone:
E-Mail Address:
3.
Business Name:
Business Address:
City:
State:
Zip Code:
(If multiple locations, please mail or e-mail a listing for each location and sales tax permit numbers)
4.
What is the dollar amount of annual purchases subject to sales or use tax?
5.
Does your accounting system have sufficient internal controls to accrue sales or use tax accurately? Y
N
6.
Can your accounting system isolate purchases for your South Dakota registered locations? Y
N
7.
Does your accounting system maintain separate general ledger accounts for sales tax collected from customers and for
sales or use tax accrued? Y
N
8.
Does your accounting system maintain separate general ledger accounts for sales or use tax paid to vendors? Y
N
9.
Provide a description of your accounting system (if more space is needed, please e-mail additional sheets):
-
-
Certification
I am requesting a Direct Payment Permit in order to pay the tax on taxable materials and services directly to the Department of
Revenue at the time of taxability, rather than to the vendor at the time of purchase and to include such payments with the monthly
sales and use tax return.
I agree to file and pay monthly sales and use tax returns
I agree to file and pay sales and use tax by electronic means
I agree that the above name may be published as a Direct Payment Permit holder on the Department’s website and in any other
related publication, and may be disclosed as a Direct Payment Permit holder in any other manner for tax administration purposes.
I DECLARE under the penalties of perjury that I am authorized to submit this application on behalf of the above-named organization
and I have examined this application, including the accompanying statements, and to the best of my knowledge it is true, correct, and
complete.
Name:
Title:
Date:
1.
or
PRINT FOR MAILING
SEND ELECTRONICALLY
CLEAR FORM
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