Missouri > Statewide > Department Of Revenue
Request For Tax Clearance 943 - Missouri
| Request For Tax Clearance Form. This is a Missouri form and can be used in Department Of Revenue Statewide . |
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MISSOURI DEPARTMENT OF REVENUE FORM REQUEST FOR TAX CLEARANCE Phone: (573) 751-9268 Fax: (573) 522-1265 E-mail: taxclearance@dor.mo.gov a ta c ea a ce@do o go COMPLETE FORM IN ITS ENTIRETY TO OBTAIN A TAX CLEARANCE 943 (REV. 06-2011) CHARTER NUMBER/CERTIFICATE OF AUTHORITY NUMBER MO TAX IDENTIFICATION NUMBER OR EXEMPTION NUMBER FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN) __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ 1. Does this business have Missouri employees for which they are required to withhold Missouri taxes? YES NO 2. Do you pay contributions to the Division of Employment Security? YES NO If yes, what is that account number? ______________ TYPE OF OWNERSHIP CORPORATION If there has been a change in the ownership of your business, you may need to contact Business Tax Registration at (573) 751-5860 to ensure your account is properly registered. PARTNERSHIP LIMITED LIABILITY COMPANY -- How are you taxed? (check one) As a corporation As a sole owner As a partnership SOLE PROPRIETORSHIP MAILING ADDRESS OF BUSINESS (NOTE: This is where the correspondence will be mailed, if the Authorization for Release of Confidential Information Section below is not completed.) NAME OF BUSINESS OR CORPORATION DOING BUSINESS AS NAME (DBA) BUSINESS MAILING ADDRESS CITY, STATE, ZIP CODE CONTACT PERSON CONTACT PHONE NUMBER ( __ __ __ ) __ __ __ - __ __ __ __ REASON FOR REQUEST (Check all that apply) 1. I am completing the following transaction with the Missouri Secretary of State's Office. Please check the appropriate box(es). Reinstatement Withdrawal/Termination Merger -- Date of Merger __ __ / __ __ / __ __ __ __ r All tax types and the account with the Division of Employment Security will be reviewed and must be filed and paid in full. 2. I am completing the following transaction: Please check the appropriate box(es). Selling Business Assets Financial Closing MBE/WBE Missouri Quality Jobs Other ___________________ All tax types and the account with the Division of Employment Security will be reviewed and must be filed and paid in full. 3. I require a sales/use tax Certificate of No Tax Due for the following: Please check the appropriate box(es). Business License Liquor License Other (if not listed) ____________________________________________________ 4. I require a sales/use tax Vendor No Tax Due to obtain or renew a contract with the State of Missouri. Please provide the contact person and phone number where they can be reached. Name: _______________________________________________________ Phone Number: ( __ __ __ ) __ __ __ - __ __ __ __ CORPORATIONS If there has been a name change for this corporation, please provide the prior name. _______________________________________________________________________________________________ This corporation files consolidated corporation income tax returns in Missouri. a. The parent corporation's FEIN that these returns are being filed under is: ___ ___ ___ ___ ___ ___ ___ ___ ___ b. The Missouri Tax Identification Number of the parent corporation is: ___ ___ ___ ___ ___ ___ ___ ___ Missouri corporation franchise tax returns cannot be filed consolidated and must be filed by each corporation. YOUR SOCIAL SECURITY NUMBER SPOUSE'S SOCIAL SECURITY NUMBER SOLE PROPRIETORSHIPS __ __ __ - __ __ - __ __ __ __ __ __ __ - __ __ - __ __ __ __ If individual income tax returns have previously been filed in another state, please provide a list of the states and years filed. Authorization for Release of Confidential Information: All correspondence will be released to the person authorized below. Release of this information to a third party (such as an accountant) at the request of the taxpayer does not give the third party authority to request further information from the department. To obtain additional information or to represent the taxpayer before the department, the taxpayer must execute a Power of Attorney designating the third party as its representative. NAME OF PERSON AUTHORIZED TO RECEIVE THIS INFORMATION TITLE PHONE NUMBER (___)___-____ ADDRESS CITY, STATE, ZIP CODE SIGNATURE OF OWNER, PARTNER, OR CORPORATE OFFICER Under penalties of perjury I declare that the above information is true and complete. SIGNATURE OF OWNER/OFFICER TITLE PHONE NUMBER ( __ __ __ ) __ __ __ - __ __ __ __ PRINTED NAME OF OWNER/OFFICER PLEASE FAX THE RESULTS OF MY TAX CLEARANCE REQUEST TO ( __ __ __ ) __ __ __ - __ __ __ __ PLEASE MAIL THE COMPLETED FORM TO: MISSOURI DEPARTMENT OF REVENUE, TAX CLEARANCE, P.O. BOX 3666, JEFFERSON CITY, MO 65105-3666 OR IT MAY BE FAXED TO: (573) 522-1265. If this form is faxed, the original is not required. MO 860-0912 (06-2011) For Privacy Notice, see the instructions. American LegalNet, Inc. www.FormsWorkFlow.com Frequently Asked Questions 1. What if I don't know my Missouri tax identification number? The Missouri tax identification number is assigned by the Missouri Department of Revenue at the time you register for the reporting of sales/use, withholding, corporation income or corporation franchise tax. If you have not registered your business or need to check on the status of a registration, please contact Business Tax Registration at (573) 751-5860. 2. What is my federal employer identification number? The Internal Revenue Service issues your federal employer identification number when you register to file federal taxes. If you do not have this number, we will review the account based on the information provided. 3. What is my corporation charter number/certificate of authority number? Your corporate charter number is issued to a Missouri corporation, limited liability company or limited partnership, by the Missouri Secretary of State's Office, authorizing your company to transact business in the State of Missouri. The certificate of authority number is issued by the Missouri Secretary of State's Office to foreign entities. Questions concerning these numbers should be directed to the Missouri Secretary of State's Office at (573) 751-4153. 4. I am a foreign corporation. Am I required to register with the Missouri Secretary of State's Office? If you are a corporation, you must be authorized to transact business in the State of Missouri with the Missouri Secretary of State's Office. Some foreign corporations may not be required to obtain a certificate of authority number in Missouri. If your corporation is not required, indicate so and the reason why. You may review Section 351.572.2 RSMo, www.moga.state.mo.us/s
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