Form 1746r - Sales Or Use Tax Exemption Renewal Application Page 2
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2Under penalties of perjury, I declare that:
• The above information and attachments are true and correct.
• I will keep informed of legislative changes and review the law to ensure the organization is in compliance.
• The organization’s activities and purpose are the same as when the exemption was originally issued.
Signature of Officer or Responsible Person
Title
Printed Name
E-mail Address
Social Security Number
Date of Birth (MM/DD/YYYY)
Date (MM/DD/YYYY)
___ ___ / ___ ___ / ___ ___ ___ ___
___ ___ / ___ ___ / ___ ___ ___ ___
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Missouri
Statute 32.057,
RSMo, states that all tax records and information maintained by the Missouri Department of
Revenue are confidential. The tax information can only be given to the owner, partner, member, or officer who is listed
with us as such. If you wish to give an employee, attorney, or accountant access to your tax information, you must supply
us with a power of attorney giving us the authority to release confidential information to them.
Form 1746R (Revised 11-2013)
Mail to:
Taxation Division
Phone: (573) 751-2836
Visit
P.O. Box 358
TDD: (800) 735-2966
for additional information.
Jefferson City, MO 65105-0358
Fax: (573) 751-9409
E-mail:
salestaxexemptions@dor.mo.gov
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