Transcription of 4924 - Non Highway Use Motor Fuel Refund Application
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4924 - Non Highway Use Motor Fuel Refund Application
Business Name or First Name MI Last Name r FEIN r Social Security NumberSpouse s First Name MI Last Name Spouse s Social Security NumberPhysical Address Mailing AddressCity or Town State ZIP Code City or Town State ZIP CodeCounty of Physical Address Location of Physical Address (Select One) E-mail Addressr Inside City Limits r Outside City LimitsTelephone Number Alternate Telephone Number Fax NumberClaimant Information(___ ___ ___)___ ___ ___-___ ___ ___ ___(___ ___ ___)___ ___ ___-___ ___ ___ ___Are you exempt from Missouri sales tax?
If no bulk storage, explain how fuel is received: _____ Select all applicable boxes. Review the instructions on back for assistance. Form. 4924. Non-Highway Use Motor . Fuel Refund Application . Mail to: Taxation Division. Form 4924 (Revised 12-2021) P.O. Box 800 Jefferson City, MO 65105-0800. Phone: (573) 751-7671. Fax: (573) 522-1720. E-mail ...
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