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Department Use Only
Form (MM/DD/YY)
Nonprotested Sales Tax Payment Report
2039
Reporting Period
(MM/YY)
Missouri Tax I.D. Federal Employer
Number I.D. Number
NPRE
Department Use Only
Owner’s Name Business Name
Mailing Address City State Zip Code
Company
E-mail Address Phone Number
(__ __ __) __ __ __ - __ __ __ __
This form is to be used in conjunction with the Sales Tax Protest Payment Affidavit (Form 163). Any nonprotested sales tax
payments in a reporting period for which you filed a Protest Payment Affidavit must be reported on this form.
Business Location Tax Type Gross Receipts Adjustments Taxable Sales Tax Rate Amount of Tax
(enter below) Indicate + or -
State - 3%
Conservation - 1/8%
Education - 1%
Parks and Soil - 1/10%
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Reset This Section Only
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Enter total amount of tax from all pages 1.
Protested Payment(s)
Final Return: If this is your final return, enter the close date below and check Subtract: 2% of Line 1 only if paid by 2.
the reason for closing your account. Missouri law requires any person selling due date............................................ –
or discontinuing business to make a final sales tax return within 15 days of the Total amount of tax due: 3.
sale or closing. (Line 1 minus Line 2) ........................ =
Add: Interest for late payment 4.
(see Instructions) .............................. +
Date Business Closed (MM/DD/YYYY) __ __ /__ __ /__ __ __ __
Add: additions to tax (5% per month 5.
late of Line 3, maximum 25%) .......... +
r Out of Business r Sold Business r Leased Business Remit single check for this 6.
amount: (add Lines 3, 4, 5)............... =
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.
Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct.
Signature Title
Signature Printed Name Date (MM/DD/YYYY)
__ __ /__ __ /__ __ __ __
Form 2039 (Revised 02-2020)
Mail to: Taxation Division Phone: (573) 526-9938
P.O. Box 3350 TTY: (800) 735-2966 Visit http://dor.mo.gov/business/sales/
Jefferson City, MO 65105-3350 Fax: (573) 751-9409 for additional information.
E-mail: salesrefund@dor.mo.gov
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