Form 5108 - Application For Tire Or Lead-Acid Battery Refund Or Credit Page 2
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2FORM 5108—APPLICATION FOR TIRE OR LEAD-ACID BATTERY REFUND OR CREDIT
ACTION TO BE TAKEN: Indicate whether you are requesting a refund or a credit by checking the appropriate box.
TAXPAYER BUSINESS NAME: Enter the name of the business requesting the refund or credit. This should be the business legally obligated
to remit the tax to the Missouri Department of Revenue.
NAME ON REFUND CHECK: This space is to be used if a refund is requested and the check is to be issued in a name other than
the taxpayer or business.
MISSOURI TAX I.D. NUMBER: Enter your MISSOURI TAX IDENTIFICATION NUMBER.
PHONE NUMBER: Phone number of the taxpayer or the taxpayer’s agent, including area code.
MAILING ADDRESS: Enter the mailing address where the approved credit or the refund check should be mailed.
POWER OF ATTORNEY: If you want the Missouri Department of Revenue to send copies of any correspondence relating to this refund
or credit claim to your power of attorney or agent, check the appropriate box. We will also send your power of attorney a copy of the final
approval or denial of the refund or credit request.
AMOUNT OVERPAID: This is the amount of tax that you have determined to be overpaid.
PERIOD(S): Indicate the tax periods involved in your Tire or Lead‑Acid Battery refund or credit request.
REASON FOR OVERPAYMENT: You must state the specific grounds upon which your claim for refund or credit is based. All claims must
contain supporting documentation for the overpayment. Supporting documents include: invoices, valid exemption certificates, worksheets, and
any other documentation required to validate the claim. You must submit amended returns for each period of your request.
The application must be signed by an owner, officer, partner or designated agent. If an agent signs the application, a power of attorney must
be submitted with the refund request.
DEPARTMENT USE ONLY: Please do not enter any information in this area.
MAILING: Mail the completed form to: Missouri Department of Revenue, Taxation Division, P.O. Box 3350, Jefferson City, Missouri 65105‑
3350.
If you have questions while completing this form, call (573) 526‑1760. Persons with speech or hearing impairments may use TDD (800) 735‑2966.
Any portion of the “interest” amount not returned to your customer(s) must be reported as interest income on your Federal Income Tax Return.
This is the only notification you will receive concerning interest income.
AMENDED RETURNS: There is not a specific amended return. To create an amended return, you can use a blank tire or lead‑acid battery
fee return. You must indicate the correct original filing period on the return and write “amended” at the top of it.
FREQUENTLY ASKED QUESTIONS
1. How do I apply for a refund or credit of tire or lead-acid battery fee?
C omplete Form 5108, Application for Tire or Lead‑Acid Battery Fee Refund or Credit and submit amended returns for the periods in which
the sales were originally reported along with supporting documentation.
2. I am filing a refund or credit claim that involves more than one filing period. Do I need to file a separate Form 5108 claim for
each period?
N o. Submit one Form 5108 for the entire claim. Make certain you indicate the periods for which the claim is being submitted. However,
you must submit amended returns for each period of your request.
3. Does the state pay interest on overpayments?
I nterest is included in a refund of overpayments only if the overpayment is not refunded within 120 days from the latest of:
• the last day prescribed for filing a return or refund claim, without regard to any extension of time granted;
• the date the return, payment or claim is filed; or
• the date the taxpayer files for a credit or refund and provides accurate and complete documentation to support the claim.
There are no statutory provisions for interest on a credit.
4. What is the oldest period for which I may request a refund or credit?
Y ou may file a refund claim within three years of the date of overpayment. The date of overpayment is the due date of the original return
or the date paid, whichever is later.
5. What is my recourse if a refund or credit claim has been denied?
A denial of refund or credit is the final decision of the Director of Revenue. A taxpayer may appeal any decision to the Administrative
Hearing Commission. Appeals must be submitted in writing to the Administrative Hearing Commission, 301 West High Street, Harry S
Truman State Office Building, PO Box 1557, Jefferson City, Missouri 65102 within 60 days after the date the decision is mailed or the date
it is received, whichever date is earlier. If your appeal is sent by registered or certified mail, the appeal will be deemed filed on the date it
is mailed. If the appeal is sent by any method other than registered mail, it will be deemed filed on the date it is received by the Adminis‑
trative Hearing Commission.
DOR‑5108 (03‑2013)
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