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1A. 1B. 1C. Total
Tire Sold Adjust. + or – Tires
2A. 2B. 2C. Total
Batteries
Tire and Lead-Acid Sold Adjust. + or – Batteries
Battery Fee Return Amended Return 3. Total Tires and Batteries Sold 0
Line 1C plus Line 2C ........... =
Missouri Tax Identification Number .50
4. Tire and Battery Fee Rate ...X $ 5 0
File Period Due Date (MM/DD/YYYY) 5. Tire and Battery Fee. 0.00
Line 3 times Line 4 (Rate) .... = $
6. Collection Deduction.
Business Name __ __ / __ __ / __ __ __ __ Line 5 times 6% ................... – $ 0.00
7. Total Fees Due. $ 0.00
Line 5 minus Line 6 ............. =
Street Address 8. Addition to Fees
(see instructions) ................ + $
9. Interest for Late Payment
City, State, and Zip Code (see instructions) ................. + $
10. Approved Credit
(see instructions) ................ – $
By signing this return I am authorizing the Department of Revenue to issue any 11. Pay This Amount (U.S. Funds)
potential refund(s). Under penalties of perjury, I declare If final return enter close total of Lines 7-9 minus Line 10 = $ 0.00
that this is a true, accurate, and complete return. I
have direct control, supervision, or responsibility for date (MM/DD/YYYY). If you pay by check, you authorize the
filing this return and payment of the fee due. __ __ /__ __ /__ __ __ __ Department of Revenue to process
Authorized Signature Date (MM/DD/YYYY) the check electronically. Any check
returned unpaid may be presented again Use Only Form 5068 (Revised 02-2021)
__ __ /__ __ /__ __ __ __ electronically. Department
*14700010001*
14700010001
Instructions for Completing Tire and Lead-Acid Battery Fee Return
If you have questions that are not covered in these instructions, you may contact Example: Return is due April 30, but is filed (postmarked) May 15.
the Department of Revenue at the addresses, e-mail addresses, and phone Line 7 is $480
numbers listed at the bottom of this page. You may also refer to our website at $480 X 5% = $24
dor.mo.gov/taxation/business/tax-types/tire-battery/. $24 is the Additions to Fees
Line 1A: Tires Sold — Enter the total number of tires sold for this report period. Enter Example: Return is due April 30, but is filed (postmarked) June 1.
zero “0” if you have nothing to report for this reporting period. Line 7 is $480
Line 1B: Adjustments — Add or subtract total qualifying adjustments. Indicate a plus $480 X 10% = $48
(+) or minus (–) sign for the adjustments. Enter zero “0” if you have nothing to report $48 is the Additions to Fees
for this reporting period. Line 9: Interest for Late Payment — If fees are not paid by the due date, multiply
Line 1C: Total Tires — Enter the total of Box 1A (Tires Sold) plus (+) or minus (–) Box Line 7 by the daily interest rate. Then multiply this amount by number of days late.
1B (Adjustments). Enter zero “0” if you have nothing to report for this reporting period. Note: Number of days late is counted from the due date to the postmark date. For
Lines 2A, 2B, and 2C: Lead-Acid Batteries — Enter the appropriate Batteries Sold, example, if the due date is April 30 and the postmark is May 15, the payment is 15
Adjustments, and Total Batteries. Refer to instructions for Line 1A, 1B, and 1C on days late.
method of calculation. Enter zero “0” if you have nothing to report for this reporting Example: If interest rate is three percent (3%) and Line 7 is $480:
period. (A) Divide the annual interest rate by 365* to get a daily rate.
Line 3: Total Tires and Lead-Acid Batteries Sold — Enter the total of Line 1C plus (.03/365 = .00008219)
Line 2C. (B) Multiply Line 7 by the daily rate.
Line 4: Tire and Lead-Acid Battery Fee Rate — The amount indicated on this line ($480 X .00008219 = .039451)
represents the Tire and Lead-Acid Battery Fee rate. (C) Multiply the result by the number of days late.
Line 5: Tire and Lead-Acid Battery Fee — Line 3 (Total Tires and Lead-Acid Batteries (.039451 X 15 days late = .59 )
Sold) multiplied (x) by Line 4 (Rate) = Line 5 (Tire and Lead-Acid Battery Fee). $ .59 is interest for late payment.
Line 6: Collection Deduction — Enter six percent (6%) of the amount shown on Line 5.
Line 7: Total Fees Due — Line 5 (Tire and Lead-Acid Battery Fee) minus (-) Line 6 Note: Divide the annual interest rate by 365 to figure the daily rate.
(Collection Deduction) = Line 7 (Total Fees Due). *Use 366 for leap years.
Line 8: Addition to Fees — For failure to pay Tire and Lead-Acid Battery Fee Return The annual interest rate is subject to change each year. You can access the annual
on or before the due date, enter five percent (5%) of Line 7. For failure to file a Tire interest rate on the Department’s website at:
and Lead-Acid Battery Fee Return on or before the due date, enter five percent (5%) dor.mo.gov/taxation/statutory-interest-rates.html.
of Line 7 for each month late up to a maximum of twenty-five percent (25%) (5 months Line 10: Approved Credit — Enter any Tire and Lead-Acid Battery Fee credit for
late in filing = 25%). which the Department issued you an approved credit. An approved credit notice must
Note: If Additions to Fees for failure to file applies, do not pay additions to fees for accompany the Tire and Lead-Acid Battery Fee Return.
failure to pay. Line 11: Pay This Amount — Line 7 plus (+) Line 8 plus (+) Line 9 minus (–) Line 10.
For example, if a return due April 30 is filed any time between May 1 and May 31, the Make remittance payable to Missouri Director of Revenue (U.S. Funds Only). Do not
rate would be five percent (5%); if filed between June 1 and June 30, the rate would send cash or stamps.
be ten percent (10%); and so on, up to a maximum of twenty five percent (25%). Sign and Date Return: Sign and date the return. If this is your final return, enter close
date in box provided.
Mail to: Taxation Division Phone: (573) 751-5860 (Technical questions or registration) Form 5068 (Revised 02-2021)
P.O. Box 3040 Phone: (573) 751-7200 (Financial status of account)
Jefferson City, MO 65105-3040 TTY: (800) 735-2966 Visit dor.mo.gov/business/tirebattery/
Fax: (573) 526-8747 for additional information.
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