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1 1 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 52 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 52 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 52 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 51 
      0 0 0  4 4 4 4 0                                                                                                              Department Use Only
      0 0 0  5 5 5 5 0                        Form          Missouri Department of Revenue                                          (MM/DD/YY)
      0 0 0  6 6 6 6 0                                      Nonprotested Use Tax Payment Report
      0 0 0  7 7 7 7 0      2038
                                                                                                                                                        Reporting Period
      0 0 0  8 8 8 8 0                                                                                                                                  (MM/YY)
      0 0 0  9 9 9 9 0 
      1 1 1  0  0  0  0  1 Missouri Tax I.D.                                                                             Federal Employer
      1 1 1  1 1 1 1 1     Number                                                                                        I.D. Number
      1 1 1  2 2 2 2 1 
      1 1 1  3 3 3 3 1                        Type of Tax Protested                                                                                                                         NPRE
                                                                            r                                                                    Department Use Only
      1 1 1  4 4 4 4 1                                                            Consumer’s Use Tax            r  Vendor’s Use Tax
      1 1 1  5 5 5 5 1                        Owner’s Name                                                               Business Name 
      1 1 1  6 6 6 6 1 
      1 1 1  7 7 7 7 1                        Mailing Address                                                            City                                      State                        Zip Code
                            Business
      1 1 1  8 8 8 8 1 
      1 1 1  9 9 9 9 1                        E-mail Address                                                                                          Phone Number 
      2 2 2  0 0 0 0 2                                                                                                                                (__ __ __) __ __ __ - __ __ __ __
      2 2 2  1 1 1 1 2                            This form is to be used in conjunction with the Use Tax Protest Payment Affidavit (Form 2041). Any nonprotested use tax 
      2 2 2  2 2 2 2 2                                    payments in a reporting period for which you filed a Protest Payment Affidavit must be reported on this form.
      2 2 2  3 3 3 3 2                            Vendor’s Use Tax                   Tax Type             Gross Receipts       Adjustments       Taxable Sales        Tax Rate                      Amount of Tax
      2 2 2  4 4 4 4 2                        Business Location (Enter below) State Use                                                                                   3%
      2 2 2  5 5 5 5 2                                                        Conservation 1/8%
      2 2 2  6 6 6 6 2                                                        Education 1%
      2 2 2  7 7 7 7 2                                                        Parks and Soil                                                                            1/10%
      2 2 2  8 8 8 8 2 
      2 2 2  9 9 9 9 2 
      3 3 3  0 0 0 0 3                        Vendor’s Use Totals                                               Enter total amount of vendor’s use tax from all pages
                                                                                                                                                                                                1.
      3 3 3  1 1 1 1 3                                                                                                                              Subtract 2% timely payment 
                                                                                                                                                                                                2.
      3 3 3  2 2 2 2 3                                                                                                                              allowance (If applicable)                   –
      3 3 3  3 3 3 3 3                                                                                                                                     Vendor’s use tax due                 3.
      3 3 3  4 4 4 4 3                                                                                                                                     (Line 1 minus Line 2)                =
                                                                                                                               Taxable Purchases               Tax Rate                         Amount of Tax
      3 3 3  5 5 5 5 3                           Consumer’s Use Tax                          Tax Type
      3 3 3  6 6 6 6 3                        Business Location (Enter below) State Use                                                                            3%
      3 3 3  7 7 7 7 3                                                        Conservation 1/8%
      3 3 3  8 8 8 8 3                                                        Education 1%
      3 3 3  9 9 9 9 3              Protested Amount(s)                       Parks and Soil                                                                       1/10%
      4 4 4  0 0 0 0 4 
      4 4 4  1 1 1 1 4 
      4 4 4  2 2 2 2 4                        Consumer’s Use Totals                                            Enter total amount of consumer’s use tax from all pages                          4.
      4 4 4  3 3 3 3 4                        Final Return: If this is your final return, enter the close date below and check the reason  Total use tax due:                                   5.
      4 4 4  4 4 4 4 4                        for closing your account. Missouri law requires any person selling or discontinuing          (add Lines 3 and 4)............................. =
      4 4 4  5 5 5 5 4                        business to make a final use tax return within 15 days of the purchase or closing.           Add:  interest for late payment                      6.
                                                                                                                                           (see instructions) ................................ +
      4 4 4  6 6 6 6 4                                                                                                                     Add:  additions to tax (5% per month                 7.
      4 4 4  7 7 7 7 4                        Date Business Closed (MM/DD/YYYY)           __ __ /__ __ /__ __ __ __                        late of Line 5, maximum 25%) ...........             +
      4 4 4  8 8 8 8 4                                                                                                                     Subtract:  approved credit                           8.
                                                      Out of Business             Sold Business           Leased Business                  (attach credit memorandum) ..............            –
      4 4 4  9 9 9 9 4                                                                                                                     Remit single check                                   9.
      4 4 4  0 0 0 0 4                        If you pay by check, you authorize the Department of Revenue to process the check            for this amount: ................................... =
      5 5 5  1 1 1 1 5                        electronically.  Any check returned unpaid may be presented again electronically.
      5 5 5  2 2 2 2 5                        Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct.
      5 5 5  3 3 3 3 5                        Signature                                                                                    Title                    
      5 5 5  4 4 4 4 5 
      5 5 5  5 5 5 5 5              Signature Printed Name                                                                                 Date (MM/DD/YYYY)
      5 5 5  6 6 6 6 5 
                                                                                                                                           __ __ /__ __ /__ __ __ __
      5 5 5  7 7 7 7 5                                                                                                                                                     Form 2038 (Revised 12-2014)
      5 5 5  8 8 8 8 5     Mail to:                  Taxation Division                          Phone: (573) 526-9938
      5 5 5  9 9 9 9 5                               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.
      5 5 5  0 0 0 0 5                                                                          E-mail:  salesuse@dor.mo.gov 
      6 6 6  1 1 1 1 6 
      6 6 6  2 2 2 2 6                                                                     *14018010001*
      6 6 6  3 3 3 3 6                                                                                         14018010001
      6 6 6  4 4 4 4 6 
      6 6 6  5 5 5 5 6 
      6 6 666 6 6 6

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Important: This report must be filed in lieu of the Missouri Use Tax Return to report all nonprotested amounts of taxes in a period for
which you filed a protest payment affidavit. Report only nonprotested payments on this report. Protest payments must be reported on
the Use Tax Protest Payment Affidavit (Form 2041).

Business Location: Enter the address of each business location for which you have the responsibility of reporting tax. Attach
Additional Copies Of This Form In Order To Report Multiple Locations.

Tax Type: The state, conservation, education and parks and soil taxes are preprinted in this column. Enter each city or county
tax type which is not being protested.

Gross Receipts: Enter all nonprotested gross receipts by each specific tax type for each business location.

Adjustments: Enter authorized adjustments. Be sure to indicate plus or minus for each adjustment.

Taxable Sales: Compute taxable sales for each entry.

Gross receipts (+) or (–) adjustments = taxable sales

Tax Rate: The state, conservation, education and parks and soil use tax rates are preprinted in this column. If you are subject to
city and county taxes, enter the local use tax rate for each city or county tax type.

Amount of Tax: Multiply taxable sales by the tax rate of each specific tax type.

Line 1 — total amount of tax: Compute total amount of taxes shown in the amount of tax column.

Line 2 — timely payment allowance: If you file and pay on or before the due date, enter 2% of the amount shown on Line 1.

Line 3 — vendor’s use tax due: Subtract Line 2 from Line 1 and enter remainder.
Protested Amount(s) Consumer’s Use Tax: You must pay consumer’s use tax on tangible personal property stored, used, or consumed in Missouri
unless you paid tax to the seller or the property is exempt from tax. A purchaser is required to file a use tax return if the
cumulative purchases subject to use tax exceed two thousand dollars in a calendar year.

Taxable Purchases: Enter nonprotested amount of taxable purchases by each specific tax type for each business location.

Tax Rate: The state, conservation, education and parks and soil use tax rates are preprinted in this column. If you are subject to
city or county taxes, enter the local use tax rate for each city or county tax type.

Amount Of Tax: Multiply taxable purchases by the tax rate of each specific tax type.

Line 4 — total amount of tax: Compute total amount of taxes shown in the amount of tax column.

Line 5 — follow instructions shown on front of form.

Line 6 — interest for late payment: If tax is not paid by the due date, multiply Line 5 by the annual percentage rate and then
multiply this amount by the number of days late divided by 365 (or 366 in a leap year). The annual percentage rate is subject to
change each year. The annual percentage rate can be obtained from our website at: http://dor.mo.gov/intrates.php.

Lines 7–9 — Follow instructions shown on front of form.

*14000000001*
14000000001
Form 2038 (Revised 12-2014)

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1 1 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 52 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 52 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 52 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 51 Page 3
      0 0 0  4 4 4 4 0     This schedule is to be used only if the space provided on page 1 of the report is insufficient to report all non-protest payments. To 
      0 0 0  5 5 5 5 0     complete this page, refer to instructions on page 2.
      0 0 0  6 6 6 6 0 
      0 0 0  7 7 7 7 0 
      0 0 0  8 8 8 8 0              Business Location              Tax Type       Gross Receipts   Adjustments Taxable Sales            Tax Rate    Amount of Tax
      0 0 0  9 9 9 9 0                                      State Use                                                                   3%
      1 1 1  0  0  0  0  1                                  Conservation 1/8%
      1 1 1  1 1 1 1 1                                      Education 1%
      1 1 1  2 2 2 2 1                                      Parks and Soil                                                              1/10%
      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 
      1 1 1  7 7 7 7 1 
      1 1 1  8 8 8 8 1 
      1 1 1  9 9 9 9 1 
      2 2 2  0 0 0 0 2 
      2 2 2  1 1 1 1 2 
      2 2 2  2 2 2 2 2 
      2 2 2  3 3 3 3 2 
      2 2 2  4 4 4 4 2                                      State Use                                                                   3%
      2 2 2  5 5 5 5 2                                      Conservation 1/8%
      2 2 2  6 6 6 6 2                                      Education 1%
      2 2 2  7 7 7 7 2                                      Parks and Soil                                                              1/10%
      2 2 2  8 8 8 8 2 
      2 2 2  9 9 9 9 2 
      3 3 3  0 0 0 0 3 
      3 3 3  1 1 1 1 3 
      3 3 3  2 2 2 2 3 
      3 3 3  3 3 3 3 3 
      3 3 3  4 4 4 4 3 
      3 3 3  5 5 5 5 3     Protested Amount(s)
      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                                      State Use                                                                   3%
      4 4 4  0 0 0 0 4                                      Conservation 1/8%
      4 4 4  1 1 1 1 4                                      Education 1%
      4 4 4  2 2 2 2 4                                      Parks and Soil                                                              1/10%
      4 4 4  3 3 3 3 4 
      4 4 4  4 4 4 4 4 
      4 4 4  5 5 5 5 4 
      4 4 4  6 6 6 6 4 
      4 4 4  7 7 7 7 4 
      4 4 4  8 8 8 8 4 
      4 4 4  9 9 9 9 4 
      4 4 4  0 0 0 0 4 
      5 5 5  1 1 1 1 5 
      5 5 5  2 2 2 2 5 
      5 5 5  3 3 3 3 5 
      5 5 5  4 4 4 4 5 
      5 5 5  5 5 5 5 5 
      5 5 5  6 6 6 6 5 
                                                                                                             Enter total here and on page 1
      5 5 5  7 7 7 7 5 
      5 5 5  8 8 8 8 5                                                                                                                      Form 2038 (Revised 12-2014)
      5 5 5  9 9 9 9 5 
      5 5 5  0 0 0 0 5 
      6 6 6  1 1 1 1 6 
      6 6 6  2 2 2 2 6                                                  *14018020001*
      6 6 6  3 3 3 3 6                                                               14018020001
      6 6 6  4 4 4 4 6 
      6 6 6  5 5 5 5 6 
      6 6 666 6 6 6

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