Form 53e-25 - Annual 25% Eedp Reconciliation Return - 25 Percent Recovered Material
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Missouri Department of Revenue
Form
Annual 25% EEDP Reconciliation Return —
53E-25
25 Percent Recovered Material
ADRE
Select one if:
Missouri Tax Identification Number
Federal Employer Identification Number (FEIN)
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Amended Return
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Additional Return
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Owner’s Name
Business Name
Reporting Period
Mailing Address
City
State
Zip Code
Due Date
January 31, 2014
Select box if
Business Phone Number
Address Correction:
Department
phone number
(__ __ __)__ __ __-__ __ __ __
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Mailing Address
Business Location
Use Only
changed
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Important: this return must be filed for the reporting period indicated even if you have no gross receipts or tax to report.
Taxable Utility Purchases
Business Location
Code
Rate (%)
Amount Of Tax
Full Rate
Manufacturing exemption (local tax only)
Totals ...........................................................................
1.
1.
Subtract: 2% timely payment allowance (if applicable) ....... 2. –
Total sales tax due ............................................................. 3. =
Add: interest for late payment.............................................. 4. +
Add: additions to tax ............................................................ 5. +
Subtract: approved credit .................................................... 6. –
Pay This Amount (U.S. Funds Only) ..............................
7. =
I hereby affirm that the raw materials used in processing per the location(s) referenced above contain at least twenty-five percent (25%) recovered
Section 260.200
RSMo. No significant product type or ingredient changes have occurred for the reporting
materials in each product as defined in
period. Recovered Materials Qualifying Product % __________________ (If multiple product lines, attach percentage information for each.)
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Select applicable box:
25%–30% recovered material — obtain vendor declaration statements, fill out Part B, Recovered Material Calculations
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30% or higher with last audit and 30% or higher for current period in recovered material content
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Section 144.030.2(13)
RSMo, rebuttable presumption that the raw materials used in the primary
In accordance with
manufacture of automobiles contain at least twenty-five percent recovered materials.
This declaration statement must be signed and dated by an authorized official of the company.
Signature
Title
Date (MMDDYYYY)
__ __ / __ __ / __ __ __ __
Product or Products Produced
Complete Section B only if you checked the first check box in Part A (25–30% recovered material)
List all raw material suppliers and percentage of recovered material content necessary to qualify for the exemption.
Name of Raw
D - Weight or Volume of
A - Description of
B - Total Weight
C - % of Recovered
E - % Recovered Materials
Material Supplier
Recovered Materials (3)
Raw Material
or Volume (1)
Material (2)
in Total Raw Materials (4)
EXAMPLE
Attach a detailed listing
Total
%
%
Check Figure (5)
(1) You can use either the weight of the materials or the volume of the materials. In either
case, you must use the same unit of measure (pounds, ounces, feet or inches).
(2) This represents the percent of recovered materials in the raw materials. Obtain this information annually from your suppliers by having them
complete the Manufacturers Declaration of Recovered Material Content
(Form
5021). These forms should be maintained with your records.
(3) Multiply the amount in Column B by the percentage in Column C.
(4) Divide amounts in Column D by the total of Column B.
(5) Check Figure: Total of Column D divided by Column B (This number should equal the total for Column E.)
The calculation in Column B determines if you qualify for this exemption for the next calendar year. (If the second or third box in Part A
is checked, you also qualify for this exemption.) If you do not qualify, it is your responsibility to notify your utility provider, withdraw your
exemption, and remit the appropriate tax to the Department of Revenue.
Form 53-E25 (Revised 12-2013)
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