Form Mt-230 - Claim For Refund Of Beverage Container Deposits printable pdf download

Form Mt-230 - Claim For Refund Of Beverage Container Deposits

MT-230

New York State Department of Taxation and Finance

Claim for Refund of Beverage

(7/14)

Container Deposits

Legal name

Taxpayer identification number

Street address

City

State

ZIP code

Mark an X for the type of refund requested

.......................................

shortfall

overpayment

(select one only; see instructions)

Computation of refund —

List the quarterly period for which you are claiming a refund and include all supporting documents

(see instructions). Attach additional sheets if necessary. Refund requests for a shortfall or overpayment must be filed separately.

Quarterly period for which refund is being claimed:

Explanation:

Certification: I hereby certify that this claim and any attachments are to the best of my knowledge and belief, true, correct, and

complete.

Name of owner, partner, or officer

Business telephone number

Date

(please print or type)

(

)

Signature of owner, partner, or officer

Title

E-mail address of owner, partner, or officer

Form Mt-230 - Claim For Refund Of Beverage Container Deposits