Form 0807-01.1 - Request For Refund Of Sales Tax

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Vendor
Vendor
Vendor
Vendor
Vendor
Statewide Integrated Financial Tools (SWIFT)
Request for Refund of Sales Tax
0807-01.1 (Revised 10/17)
Agency:
Business Unit:
Contact:
Phone:
Date:
Reason for Refund Request:
Description of Goods or Service:
Vendor
City Goods or
Voucher
Sales Tax
Sales
Amount of
Correct Tax
Number
Vendor Name
Vendor City, State
Services were
Number
to be
Tax %
Tax Paid
Amount
(ten digits)
Delivered to
(eight digits)
Refunded
1
2
3
4
5
nk
blank
blank
blank
TOTALS:
blank
SWIFT ChartFields
STATEWIDE
PC
FUND
FINANCIAL
APPROPRIATION
SOURCE
SUB­
ACCOUNT
SW COST
BUSINESS
PROJECT
ACTIVITY
CATEGORY
CODE
DEPARTMENT ID
ID (CF3)
TYPE
CATEGORY
(PROGRAM)
UNIT
Agency Approva l:
Finance Approval:
Fax: 651-797-1306 Attn: System Compliance Unit
Email:
syscomp.MMB@state.mn.us
Page 1 of 2

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