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      0 0 0  4 4 4 4 0                                                                                                                        Department Use Only
      0 0 0  5 5 5 5 0                      Form                                                                                              (MM/DD/YY)
      0 0 0  6 6 6 6 0                                       2022 Individual Consumer’s Use Tax Return 
      0 0 0  7 7 7 7 0          4340                                                                                                                                   Reporting Period
      0 0 0  8 8 8 8 0                                                 Due Date: 04/17/2023                                                                            (MM/YY)                     1 2               2 2
      0 0 0  9 9 9 9 0 
      1 1 1  0  0  0  0  1 Missouri Tax I.D.                                                                                                  *22021010001*
      1 1 1  1 1 1 1 1     Number                                                                                                                                      22021010001
      1 1 1  2 2 2 2 1     .2. Last Name                                                                             First Name                                                M.I.      SSN  
      1 1 1  3 3 3 3 1 
      1 1 1  4 4 4 4 1      Street Address                                                                           City                                                                           State    Zip
      1 1 1  5 5 5 5 1 
                            3. Spouse’s Last Name                                                                    First Name                                                M.I.      Spouse SSN 
      1 1 1  6 6 6 6 1 
      1 1 1  7 7 7 7 1      Street Address                                                                           City                                                                           State    Zip
      1 1 1  8 8 8 8 1 
      1 1 1  9 9 9 9 1                                      4. Street Address                                     City                     Zip      5. Inside  6. City/County       7. Taxable      8. Tax        9. Amount of
      2 2 2  0 0 0 0 2                                                                                                                              City Limits        Code(s)      Purchases           Rate         Tax   
      2 2 2  1 1 1 1 2                                                                                                                                    Yes          
      2 2 2  2 2 2 2 2                                                                                                                                    Yes          
      2 2 2  3 3 3 3 2 
      2 2 2  4 4 4 4 2                                                                                                                                    Yes          
      2 2 2  5 5 5 5 2      15. Provide a description of purchases you made                                                                                                     10. Total Purchases          11. Total Due
      2 2 2  6 6 6 6 2                                                                                                                                                                                       12.
      2 2 2  7 7 7 7 2                                                                                                                                                                    Interest For  
                                                                                                                                                                                         Late Payment
      2 2 2  8 8 8 8 2                                                                                                                                                                                       13.
                            16. r One time purchase     r I expect to make future taxable purchases. (see instructions)                                                                Additions To Tax
      2 2 2  9 9 9 9 2 
      3 3 3  0 0 0 0 3      I have direct control, supervision, or responsibility for filing this return and payment of the tax due.  Under penalties of perjury, I declare            Pay This Amount       14.
                            that this is a true, accurate, and complete return.                                                                                                         (U.S. Funds Only)
      3 3 3  1 1 1 1 3      17. Signature(s)                                                               Date (MM/DD/YYYY)          Daytime Telephone
      3 3 3  2 2 2 2 3                                                                                     __ __ /__ __ __ / __ __ __ (__ __ __)__ __ __–__ __ __ __            DOR ONLY
      3 3 3  3 3 3 3 3      Make check payable to the address listed below. Do not send cash. You may not use your individual income tax refund to pay your use tax liability. Do not send with individual 
      3 3 3  4 4 4 4 3      income tax return. If you pay by check, you authorize the Department of Revenue to process the check electronically. Any check returned unpaid may be presented again electronically.
      3 3 3  5 5 5 5 3 
                                            This form is not intended for use by businesses. Businesses that have a use tax liability should contact the Department of Revenue. 
      3 3 3  6 6 6 6 3                      See the address and phone number below.
      3 3 3  7 7 7 7 3 
      3 3 3  8 8 8 8 3                      What is Consumer’s Use Tax? - Use tax is imposed on the storage, use, or              5.  Select  the  box  “Yes”  if  your  address  is  inside  the  city  limits.  This 
                                            consumption of tangible personal property in this state. You must pay                    information is used to determine the correct tax rate. 
      3 3 3  9 9 9 9 3                      consumer’s use tax on tangible personal property stored, used, or consumed            6.  Enter  the  jurisdiction  code  for  your  address.  These  codes  can  be  found  at   
      4 4 4  0 0 0 0 4                      in Missouri unless you paid tax to the seller or the property is exempt from tax.        dor.mo.gov/taxation/business/tax-types/sales-use/rate-tables/.
                                            If an out-of-state seller does not collect use tax from the purchaser, the            7.  Enter the taxable purchases for each reporting location during the tax period. 
      4 4 4  1 1 1 1 4                      purchaser is responsible for remitting the use tax to Missouri. A purchaser is           Enter zero if you made no taxable purchases at a location during the tax period. 
      4 4 4  2 2 2 2 4                      required to file a use tax return if the cumulative purchases subject to use          8.  Enter the tax rate found at      dor.mo.gov/taxation/business/tax-types/sales-use 
      4 4 4  3 3 3 3 4                      tax exceed $2,000 in a calendar year. Use tax is computed on the purchase                /rate-tables/.  Select  the  use  tax  rate  where  you  reside  unless  you  are  
                                            price of the goods. Please refer to the Department’s website for additional              storing, using, or consuming tangible personal property at a different location. For  
      4 4 4  4 4 4 4 4                      information: dor.mo.gov/taxation/individual/tax-types/consumers-use.html.                qualifying food purchases you will use the food use tax rate. For aircraft 
      4 4 4  5 5 5 5 4                      Taxable Purchases - Compile a list of all purchases you made during the                  purchases referenceForm(          5741), Aircraft Consumer’s Use Tax Return.
      4 4 4  6 6 6 6 4                      calendar year and didn’t previously pay Missouri sales or use tax. You can find       9.  Enter the amount of tax by multiplying taxable purchases times the tax rate. 
      4 4 4  7 7 7 7 4                      this information from invoices, bills, credit card statements, and canceled           10. Enter total taxable purchases. 
                                            checks. Examples are purchases you made from the Internet, catalogs, food             11. Enter total tax due. 
      4 4 4  8 8 8 8 4                      purchases, TV, or telephone marketing, goods from foreign countries, and              12. Enter  interest  for  late  payment.  The  interest  rate  is  subject  to  change  each 
      4 4 4  9 9 9 9 4         Instructions aircraft. The total of all purchases during the year that were not previously taxed      year. Refer to the Department’s website           dor.mo.gov/calculators/interest/       to  
                                            must be used in computing the amount of use tax due.                                     calculate the amount of interest due. 
      4 4 4  0 0 0 0 4                                                                                                            13. Enter the amount of additions to tax. The rate is 5 percent per month of total  
                                            Due Date - The due date each year is April 15. When the due date falls on a              tax  due,not  to  exceed  25  percent.  Refer  to  the  Department’s  website  at 
      5 5 5  1 1 1 1 5                      Saturday, Sunday, or a legal holiday, the return and payment are considered              dor.mo.gov/calculators/interest/ to calculate the amount of additions due.
      5 5 5  2 2 2 2 5                      timely if made on the next business day.                                              14. Enter the sum of Lines 11 through 13. 
      5 5 5  3 3 3 3 5                                                                                                            15. Enter a description of the purchases you made subject to use tax. 
      5 5 5  4 4 4 4 5                      Line by Line Instructions                                                             16. Select one of the boxes. You will be issued a Missouri Tax ID number to 
      5 5 5  5 5 5 5 5                        1.  Enter your Missouri Tax ID Number. If you do not have a number, leave blank.       process your return, but you will not be required to register with the 
                                              2.  Enter your full name, Social Security Number and complete address.                 Department. If you have ongoing purchases, you will receive a preprinted  
      5 5 5  6 6 6 6 5                        3.  Enter your spouse’s full name, Social Security Number and complete address.        Consumer’s Use Tax Return (       Form 53-C       ) to complete each year by April 15,  
      5 5 5  7 7 7 7 5                        4.  List each address where the property purchased is stored, used or                  unless you request a different filing frequency. 
      5 5 5  8 8 8 8 5                           consumed.                                                                        17. Sign, date, and enter your daytime telephone number. 

      5 5 5  9 9 9 9 5                                    The use tax rates may be found on the Internet at:dor.mo.gov/taxation/business/tax-types/sales-use/rate-tables/2022/.
      5 5 5  0 0 0 0 5                                                                                                      businesstaxprocessing@dor.mo.gov                                            Form 4340 (Revised 12-2022)
      6 6 6  1 1 1 1 6     Mail to:                Taxation Division                                           E-mail:
                                                  P.O. Box 840 
      6 6 6  2 2 2 2 6                            Jefferson City, MO 65105-0840                                Ever served on active duty in the United States Armed Forces? 
      6 6 6  3 3 3 3 6                                                                                         If yes, visitdor.mo.gov/military/ to see the services and benefits we offer to all eligible 
                            Phone:                 (573) 751-2836                                              military individuals. A list of all state agency resources and benefits can be found at 
      6 6 6  4 4 4 4 6                      Fax:   (573) 522-1762                                              veteranbenefits.mo.gov/state-benefits/.
      6 6 6  5 5 5 5 6          TTY:               (800) 735-2966 
      6 6 666 6 6 6 






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