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                            Form
                                Purchaser’s Claim Under Section 144.190.4 
                   472P         for Sales or Use Tax Refund

                           Submit the listed items to ensure the Department of Revenue can process your claim. All required information 
                           must be submitted to avoid a delay or denial.
                           Claim Form - A fully completed and signed Purchaser’s Claim Under Section 144.190.4(2) for Sales or Use Tax Refund (Form 472P).
                           Exemption Certification and Letters - A copy of all exemption certificates or exemption letters for the exempt purchases in your claim.
                           Worksheet - A worksheet (any format) detailing how you calculated the refund amount.
                           Invoices - Invoices supporting the claim. 
                           Refunds in Excess of $100,000 - If you request a refund of $100,000 or more, it will be processed through Automated Clearing  
                             House (ACH). Submit an Agreement to Receive Refund by ACH Transfer (Form 5378). Visit dor.mo.gov/forms  / to obtain Form 5378.
                           Additional Verification, As Requested - The Department may ask for additional records to verify a claim, such as documentation of 
                             returns filed in electronic format or a listing of all items on which tax was accrued and paid for the periods a refund is being requested.  
                             You will be given a reasonable amount of time to comply with the request.
                           Power of Attorney - If someone other than an owner, partner, or officer is the contact person for this claim, an executed Power  
                             of Attorney (Form 2827) must be submitted. If the power of attorney should receive copies of the correspondence relating to the  
                             claim and the final approval or denial, check the appropriate box in the Purchaser and Seller Information section on the claim. 
                           Consumer’s Use Tax - If you are requesting a refund of consumer’s use tax you paid directly to the Department, submit amended 
Required Documents           returns for the period(s) in which you originally reported the tax. You do not need to submit Form 5433 or Form 5440 as  
                             described below under the Assignment of Rights heading.
                           Assignment of Rights - If you are requesting a refund of sales or vendor’s use tax, you must submit a completed Form 5433 or Form  
                             5440 with your claim. As the purchaser, you can request a refund with the seller’s approval by contacting the seller to complete an  
                             Assignment of Rights From The Seller To Purchaser For Refund Under Section 144.190.4(2) (Form 5433). If you are unable to  
                             obtain a completed Form 5433 from the seller, you may complete a Statement Confirming Purchaser’s Efforts To Obtain An  
                             Assignment of Rights From The Seller For Refund Under Section 144.190.4(2) (Form 5440). Form 5433 must be signed by an  
                             officer, power of attorney, or an employee of the seller. If the person signing the Form 5433 is not registered with the Department  
                             as an officer, it must be accompanied by a Power of Attorney (Form 2827) or a letter from the signatory’s immediate supervisor  
                             on company letterhead authorizing the employee to act on the seller’s behalf.
                           A notarized Form 5433 or Form 5440 must be provided when submitting the application.

                           1.   I am filing a claim that involves more than one filing period. Do I need to file a separate Form 472P claim for each period?  
                             No. Submit one l Form 472P for the entire claim. Indicate the periods for which the claim is being submitted. If your claim is for            
                             multiple consumer’s use tax periods, you are still required to submit amended returns for each period of your claim.
                           2.  Does the state pay interest on overpayments?
                             Usually not. Interest is included in a refund only if the overpayment is not refunded within 120 days from the latest of: - the last day  
                             prescribed for filing a tax return or refund claim, without regard to any extension of time granted;
                             - the date the return, payment or claim is filed; or
                             - the date the taxpayer files for a refund and provides accurate and complete documentation to support the claim.
                           3.  What is the oldest period for which I may request a refund?
                             Prior to August 28, 2019 you may file a request for refund within three years of the due date of the original return or the date paid by  
                             the seller or vendor, whichever is later. 
                             Effective August 28, 2019 Senate Bill 87 was enacted allowing a request for a refund to be filed within ten years of the due date of   
                             the original return or the date paid by the seller or vendor, whichever is later. 
Frequently Asked Questions 4.  What is my recourse if a claim has been denied?
                             A denial of a claim is the final decision of the Director of Revenue. A taxpayer may appeal any decision to the Administrative                
                             Hearing Commission (AHC). Appeals must be submitted in writing to the Administrative Hearing Commission, 301 West High                        
                             Street, Harry S. Truman State Office Building, P.O. Box 1557, Jefferson City, Missouri 65105 within 60 days after the date the                
                             decision is mailed or the date it is delivered, whichever date is earlier. If your appeal is sent by registered or certified mail, the  
                             appeal will be deemed filed on the date it is mailed. If the appeal is sent by any method other than registered mail, it will be deemed    
                             filed on the date it is received by the AHC.

                                                                                                                                        Form 472P (Revised 07-2023)



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      0 0 0  4 4 4 4 0                                                                                                                                                                            Department Use Only
                                                        Form                                                                                                                                      (MM/DD/YY)
      0 0 0  5 5 5 5 0                                                   Purchaser’s Claim Under Section 144.190.4 
      0 0 0  6 6 6 6 0                          472P                     for Sales or Use Tax Refund
      0 0 0  7 7 7 7 0 
      0 0 0  8 8 8 8 0 
      0 0 0  9 9 9 9 0 
                                     Seller Missouri                                                                                                                   Seller Federal
      1 1 1  0  0  0  0  1 
                                     Tax I.D. Number                                                                                                                   Employer I.D. Number
      1 1 1  1 1 1 1 1 
      1 1 1  2 2 2 2 1                                                                                                        Claim Number (Department Use Only)                                                   Certified Number (Department Use Only)
      1 1 1  3 3 3 3 1 
      1 1 1  4 4 4 4 1 
      1 1 1  5 5 5 5 1 
      1 1 1  6 6 6 6 1                          Please check the action to be taken:  r  Credit                                                      r  Refund 
      1 1 1  7 7 7 7 1                                  Seller Name 
      1 1 1  8 8 8 8 1 
      1 1 1  9 9 9 9 1                                  Mailing Address                                                                                                                                                 
      2 2 2  0 0 0 0 2 
      2 2 2  1 1 1 1 2                                  City                                                                                                           State                      Zip Code                 Phone Number 
      2 2 2  2 2 2 2 2                Seller Information
                                                                                                                                                                                                                           (__ __ __) __ __ __ - __ __ __ __
      2 2 2  3 3 3 3 2 
      2 2 2  4 4 4 4 2                                  Name of Purchaser                                                                                                       Name on refund check, if different than purchaser
      2 2 2  5 5 5 5 2 
      2 2 2  6 6 6 6 2                                  Missouri Tax Identification Number                                    Purchaser FEIN                                                                     Contact Telephone Number
      2 2 2  7 7 7 7 2 
      2 2 2  8 8 8 8 2                                         |        |        |        |        |        |        |                      |        |        |        |        |        |        |        |     ( ___ ___ ___ ) - ___ ___ ___ - ___ ___ ___ ___
      2 2 2  9 9 9 9 2                                  Address                                                                                                                  City                                  State                     ZIP Code
      3 3 3  0 0 0 0 3                Purchaser 
      3 3 3  1 1 1 1 3                                  Do you want the Department of Revenue to send copies of any correspondence relating to this refund and the final refund approval or denial to 
      3 3 3  2 2 2 2 3                                  your attorney?           r  No  r  Yes    (If yes, include a copy of the Power of AttorneyForm(                                                    2827) with the refund application.)
      3 3 3  3 3 3 3 3 
      3 3 3  4 4 4 4 3 
      3 3 3  5 5 5 5 3                          Reason for Refund Request- Explain the specific grounds upon which your claim for a refund or credit is based. If your refund is for an amount 
                                                that exceeds $100,000, an Agreement to Receive Refund by ACH Transfer (Form 5378) is required.
      3 3 3  6 6 6 6 3 
      3 3 3  7 7 7 7 3 
      3 3 3  8 8 8 8 3 
      3 3 3  9 9 9 9 3 
                                                        Provide Specific Statute Sales/Use Tax is Exempt Under:
      4 4 4  0 0 0 0 4 
      4 4 4  1 1 1 1 4                                         Period Ending               Requested Refund or                                       Period Ending               Requested Refund or                   Period Ending              Requested Refund or 
                                                                                                   Credit Amount                                                                         Credit Amount                                               Credit Amount
      4 4 4  2 2 2 2 4 
      4 4 4  3 3 3 3 4                                  1                                  $                                                5                                    $                                 9                              $
      4 4 4  4 4 4 4 4                                  2                                  $                                                6                                    $                                 10                             $
                                                        3                                  $                                                7                                    $                                 11                             $
      4 4 4  5 5 5 5 4                Refund information
      4 4 4  6 6 6 6 4                                  4                                  $                                                8                                    $                                 12                             $
      4 4 4  7 7 7 7 4 
      4 4 4  8 8 8 8 4                                                                                                                                                 13.    Total Amount Requested * (Add Lines 1 - 12)                         $
      4 4 4  9 9 9 9 4                                  *If refund is being requested for more than 12 periods, attach a separate schedule breaking down each period as shown in above table. 
      4 4 4  0 0 0 0 4                                                                                                                      Enter the total for all periods on LIne 13.
      5 5 5  1 1 1 1 5 
      5 5 5  2 2 2 2 5                              Under penalties of perjury, I declare that the above information and any attached supplement is true, completed, and correct.
      5 5 5  3 3 3 3 5                              Signature of Purchaser or Power of Attorney                                                                                          Printed Name
      5 5 5  4 4 4 4 5 
      5 5 5  5 5 5 5 5                Signature       I confirm that amI the following (check one)                                                                                       Date (MM/DD/YYYY)
      5 5 5  6 6 6 6 5                                  r  Taxpayer       r  Power of Attorney
                                                                                                                                                                                         ___  ___ / ___  ___ / ___  ___  ___  ___
      5 5 5  7 7 7 7 5                                                                                                                      E-mail:  salesrefund@dor.mo.gov                                                                       Form 472P (Revised 07-2023)
      5 5 5  8 8 8 8 5               Mail to:   Taxation Division
      5 5 5  9 9 9 9 5                                            P.O. Box 3350                                                             Visit dor.mo.gov/taxation/business/tax-types/sales-use/ for additional information.
      5 5 5  0 0 0 0 5                                          Jefferson        City, MO 65105-3350
      6 6 6  1 1 1 1 6                                                                                                                      Ever served on active duty in the United States Armed Forces? 
                                      Phone:                      (573) 526-9938                                                            If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible 
                                                        Fax:  
      6 6 6  2 2 2 2 6                                            (573) 751-9409                                                            military individuals. A list of all state agency resources and benefits can be found at                           
      6 6 6  3 3 3 3 6                                  TTY:   (800) 735-2966                                                               veteranbenefits.mo.gov/state-benefits/.
      6 6 6  4 4 4 4 6 
      6 6 66 6 6  5 5 5 5 66 6 6 6 6 






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