Affidavit For A Business Filing A Claim Of Refund For Consumers Sales And Service Tax Or Use Tax printable pdf download

Affidavit For A Business Filing A Claim Of Refund For Consumers Sales And Service Tax Or Use Tax

WV/CST-AF2

(Rev. 10/99)

West Virginia

State Tax Department

AFFIDAVIT FOR A BUSINESS FILING A CLAIM OF REFUND FOR

CONSUMERS SALES AND SERVICE TAX OR USE TAX

See requirements on reverse side

If tax was paid to a vendor on a purchase which is specifically exempt from the Consumers Sales and Service

or Use Tax, you must use form WV/CST-240 to apply for a refund or credit .

TAX ID NUMBER

NAME

STREET ADDRESS

CITY, STATE, ZIP CODE

TELEPHONE NUMBER

Check appropriate box:

Refund

Credit

STATE OF

COUNTY OF

, being duly sworn, depose and say that I am

(Name)

(Position or Title)

of the

, of

(Company)

(City, State and Zip Code)

and that I am fully acquainted with the books and records of said company, and that I am duly authorized to make this affidavit

for the above named company. I further depose and say that the reason for the overpayment is (describe in detail):

(Signature)

(Date)

Taken, subscribed and sworn before me this _________ day of _______________________________, 19 _____________.

My commission expires on ___________________________________________________________________________.

(NOTARY SEAL)

(Notary Public)

Affidavit For A Business Filing A Claim Of Refund For Consumers Sales And Service Tax Or Use Tax