Form St11 - Sales And Use Tax Refund Request And Multiple Period Amended Return Page 3
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6Instructions and Sample Worksheets
Sales Tax Paid in Error to a Vendor
If you charged sales tax to your customers or accrued use tax in error, you can’t request a purchaser refund. File an amended return in
e-Services, or see the instructions for filing a multiple period return.
Sample Worksheet for Sales Tax Paid in Error to a Vendor
The examples are for reference only. Add a column for each local tax.
Invoice
Invoice
Vendor Name
Item Purchased
Mo/yr tax
Purchase
Total tax
MN tax
St. Cloud
Reason for request
Date
Number
was paid
price paid
paid
area tax
3/14/15
7026
XYZ Corporation
Lubricants
3/15
$1000
$78.75
$68.75
$5 .00
Consumed in industrial production
3/22/15
7050
XYZ Corporation
Product Labels
4/15
$2500
$196.88
$171.88
$12.50
Product ID labels used in industrial
production
2/21/16
1371
ABC of St . Paul
Brochures - 95% exempt
2/16
$5000
$393.75
$343.75
$25 .00
95% of advertising is used outside MN
sent out of state
TOTAL
$8500
$669.38
$584.38
$42.50
Construction Exemption for Special Projects
This is a limited exemption. See Minnesota Statutes 297A.71 for a list of qualifying projects.
If a contractor paid tax, provide a statement showing the amount of sales or use tax each contractor paid.
Sample Worksheet for Construction Exemptions
The examples are for reference only. Add a column for each local tax.
Invoice
Invoice
Vendor Name
Item
Specify sales
Mo/yr tax
Purchase
Total tax
MN tax
Rochester tax
Olmsted County
Date
Number
Purchased
or use tax
was paid
price paid
paid
Transit tax
7/23/15
741
Construction Supply Co
Lumber
Sales
7/15
$5,000
$381.25
$343.75
$25 .00
$12.50
9/10/15
6832
XYZ Builders
Tile
Sales
9/15
$2,500
$190.63
$171.88
$12.50
$6.25
4/16/16
5589
ABC Supplies
Paint
Sales
4/16
$1,000
$76.25
$68.75
$5 .00
$2 .50
TOTAL
$8,500
$648.13
$584.38
$42.50
$21.25
Greater Minnesota Job Expansion
If you have a certified facility with a Business Subsidy Agreement (BSA), use this form to request a refund. If a contractor paid tax, provide a
statement showing the amount of sales or use tax each contractor paid.
Sample Worksheet for Greater Minnesota Job Expansion
The examples are for reference only. Add a column for each local tax.
Invoice
Invoice
Vendor Name
Item Purchased
Specify sales
Mo/yr tax
Purchase price
Total tax paid
MN tax
Worthington tax
Date
Number
or use tax
was paid
paid
7/14/16
1432
XYZ Corporation
Lubricants
Sales
7/16
$100
$7.38
$6.88
$0 .50
12/22/15
651
XYZ Corporation
Paint Supplies
Sales
12/15
$250
$18.44
$17.19
$1.25
6/21/16
976
ABC of St . Paul
Lumber
Sales
6/16
$500
$36.88
$34 .38
$2 .50
TOTAL
$850
$62.70
$58.45
$4.25
Job Opportunity Building Zone (JOBZ)
If you have a JOBZ business, use this form to request a refund for taxes paid on construction materials and supplies to construct real property
in the Zone.
If a contractor paid tax, provide a statement showing the amount of sales or use tax each contractor paid.
Sample Worksheet for JOBZ
The examples are for reference only. Add a column for each local tax.
Invoice
Invoice
Vendor Name
Item Purchased
Specify
Mo/yr tax
Purchase
Total tax
MN tax
Date
Number
sales or use
was paid
price paid
paid
tax
3/7/15
26088
Forklift Co Inc
Forklift hydraulic hose
Sales
3/15
$58 .00
$3.99
$0.27
6/25/15
66645
ABC Supply Co
Shelving
Sales
6/15
$325 .00
$22 .34
$1.54
8/22/15
100245
XYZ Leasing
Canon printer lease
Sales
8/15
$250 .00
$17.19
$1.18
TOTAL
$633.00
$43.52
$2.99
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