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 Form         Missouri Department of Revenue                          Complete and submit this voucher if the status of your 
5633          Final Report                                            business or sales and use tax location has changed.    Print Form
                                                                                             Bond Refund
Tax Type Closing (Select all that apply)                              If you filed a final return, paid all taxes, penalties and interest due, and have a 
                                                                      transient employer or sales and use tax cash bond or certificate of deposit on 
 r Sales and Use Tax                       r Employer Withholding Tax file, you may request a return of the bond by completing the following.
Missouri Tax I.D. Number                                              Amount of Bond 
                                                                      $
Business Name                                                         Return Bond To:
Owner’s Name                                                          Name                                      Title
Date Account or Location Closed (MM/DD/YYYY)                          Address                City               State        ZIP Code
__ __ /__ __ /__ __ __ __
Reason For Closing (select all that apply)                            Signature                                 Telephone Number
r Out of Business        r Sold            r  No Employees                                                      (__ __ __) __ __ __ - __ __ __ __
r Other (Explain) _______________________________________________                    Mail To:  Taxation Division
                                                                                             PO Box 3300
 Complete This Section If Closing Only One Sales and Use Tax Location                        Jefferson City, MO 65105-3300
Physical Business Address Or Item Tax Of the Location You are Closing
                                                                                *15505010001*
                                                                                             15505010001
                                                                                                                Form 5633 (Revised 08-2015)