Fillable Missouri DOR - Form 126 Registration or Exemption Change Request

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Missouri DOR - Form 126 Registration or Exemption Change Request

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The Missouri DOR - Form 126 Registration or Exemption Change Request form is 3 pages long and contains:

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This form can be used to make changes to your sales and use, employer withholding, corporate income or franchise tax, or exemption registration
records. Only complete the section(s) that apply to the changes you wish to make.
Select one r I am updating my business tax account r I am updating my sales and use exemption account
( ___ ___ ___ ) ___ ___ ___ - ___ ___ ___ ___
Name Currently On File Phone Number
Address Currently On File City State Zip Code
Change Owner Name To: (If there has been a change in ownership, a Missouri Tax Registration Application (Form 2643) must be completed in lieu of this form.
Also, if your organization is incorporated, your name must be changed with the Missouri Secretary of State’s Office before your account can be updated).
Change Business Name (Doing Business As) To
Change Owner or Organization Street Address To
City State Zip Code County
Name and Address
All information is required if completing the Ofcers, Partners, or Members Section. Attach a list if needed.
Business Tax Accounts: Adding persons indicates they have direct supervision or control over tax matters. If adding or deleting partners from a partnership
account, all partners must sign this form including the partner being deleted or added. If deleting partners and only one partner remains, you must close
your partnership account and complete Form 2643 to apply for a new sole owner account. Sales and Use Exemption Accounts: Only ofcers of the
organization can be added to your account. All other persons must obtain a Missouri Power of Attorney (Form 2827).
Title Begin or End Date (MM/DD/YYYY) Name (Last, First, Middle Initial)
Title Social Security Number FEIN
Birthdate (MM/DD/YYYY) Home Address
City State Zip Code County
| | | | | | | |
rAdd rRemove
__ __ / __ __ / __ __ __ __
__ __ / __ __ / __ __ __ __
| | | | | | | |
Title Begin or End Date (MM/DD/YYYY) Name (Last, First, Middle Initial)
Title Social Security Number FEIN
Birthdate (MM/DD/YYYY) Home Address
City State Zip Code County
| | | | | | | |
rAdd rRemove
__ __ / __ __ / __ __ __ __
__ __ / __ __ / __ __ __ __
| | | | | | | |
Officers, partners, or Members
Missouri Department of Revenue
Registration or Exemption Change Request
*15600010001*
15600010001
Department Use Only
(MM/DD/YY)
Missouri Tax I.D.
Number
Federal Employer
I.D. Number
Form
126
Title Begin or End Date (MM/DD/YYYY) Name (Last, First, Middle Initial)
Title Social Security Number FEIN
Birthdate (MM/DD/YYYY) Home Address
City State Zip Code County
| | | | | | | |
rAdd rRemove
__ __ / __ __ / __ __ __ __
__ __ / __ __ / __ __ __ __
| | | | | | | |
Please print on white paper only
Reset Form
Print Form
Close the following business location for: rConsumer’s Use Tax rEmployer Withholding Tax rSales Tax rVendor’s Use Tax
Business Name Address
City State
Zip Code County Date of Closing (MM/DD/YYYY)
Close Location
__ __ / __ __ / __ __ __ __
Mailing Address
Change For: rAll Tax Types rCorporate Income and Franchise Tax rEmployer Withholding Tax rSales and Use Tax
In Care Of (Optional) Company Name if different from owner
Address City State Zip Code County
*15600020001*
15600020001
Authorized Representatives
Title Begin or End Date (MM/DD/YYYY) Name (Last, First, Middle Initial)
Title Social Security Number Birthdate (MM/DD/YYYY)
Home Address
City State Zip Code County
| | | | | | | |
rAdd rRemove
__ __ / __ __ / __ __ __ __
__ __ / __ __ / __ __ __ __
All information is required if completing the Authorized Representatives Section. Attach a list if needed.
Business Tax Accounts: Identify all persons who are not a partner, member (L.L.C), or ofcer of the business that have direct supervision or
control over tax matters whom you authorize the Department to discuss your tax matters. All other persons must obtain a Missouri Power of
Attorney (Form 2827). Attach a list if needed.
Open the following new business location for: rConsumer’s Use Tax rEmployer Withholding Tax rSales Tax rVendor’s Use Tax
Business Name Taxable Sales Begin Date (MM/DD/YYYY
Street or Highway Address (Do not use Rural Route or PO Box)
City State Zip Code County
___ ___ / ___ ___ / ___ ___ ___ ___
Open Location
Page 2
Title Begin or End Date (MM/DD/YYYY) Name (Last, First, Middle Initial)
Title Social Security Number Birthdate (MM/DD/YYYY)
Home Address
City State Zip Code County
| | | | | | | |
rAdd rRemove
__ __ / __ __ / __ __ __ __
__ __ / __ __ / __ __ __ __
Title Begin or End Date (MM/DD/YYYY) Name (Last, First, Middle Initial)
Title Social Security Number Birthdate (MM/DD/YYYY)
Home Address
City State Zip Code County
| | | | | | | |
rAdd rRemove
__ __ / __ __ / __ __ __ __
__ __ / __ __ / __ __ __ __
Change the corporation taxable year end to:
(MM/DD) __ __ / __ __
Withholding Tax
Corporate Income Tax
*Continue current
ling until this
change is veried
by the Department.
Registration Change
Mail to: Taxation Division Phone: (573) 751-5860
P.O. Box 3300 TTY: (800) 735-2966
Jefferson City, MO 65105-3300 Fax: (573) 522-1722
E-mail: businesstaxregister@dor.mo.gov
Visit
http://dor.mo.gov/business/register/
for additional information.
Signature Printed Name
Title Date (MM/DD/YYYY)
Signature
___ ___ / ___ ___ / ___ ___ ___ ___
Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct. This form must be signed by the owner, if
the business is a sole ownership; partner, if the business is a partnership; reported officer, if the business is a corporation, or by a member, if the business is an L.L.C.
as reported on the application.
Page 3
Is this business located inside the city limits of any city or municipality in Missouri? For help determining this visit https://dors.mo.gov/tax/strgis/index.jsp.
rNo rYes - Specify the city:
Is this business located inside a district(s)? For example, ambulance, re, tourism, community, or transportation development.
rNo rYes - Specify the district name(s):
Change Sales and Use Tax Filing Frequency To: rMonthly ($500 or more per month in tax) rQuarterly (Less than $500 per month in tax)
rAnnually (Less than $100 per quarter in sales tax) *Continue current ling until this change is veried by the Department.
Do you make retail sales of the following items? Select all that apply.
rAlcoholic Beverages rAlternative Nicotine rCigarettes or Other Tobacco Products rDomestic Utilities
rE-Cigarettes or Vapor Products rFood Subject to Reduced State Food Tax Rate rItems Qualifying for Show Me Green Sales Tax Holiday
rItems Qualifying for Back-To-School Sales Tax Holiday rLead-Acid Batteries rLease or Rent Motor Vehicles
rNew Tires r Post-Secondary Educational Textbooks rTelecommunication Services
rQualifying Utilities or Items Used or Consumed in Manufacturing or Mining, Research and Development, or Processing Recovered Materials.
Do you make retail sales of aviation jet fuel to Missouri customers? .............................................................................................. r Yes rNo
If yes, are your sales made at: rA Missouri airport rA location outside Missouri and the fuel is transported into Missouri?
If yes, is the airport located in Missouri and identied on the National Plan of Integrated Airport Systems (NPIAS)? ..................... r Yes rNo
If yes, provide a list of applicable locations. ________________________________________________________________________________
Do you use, store, or consume aviation jet fuel in Missouri where the seller does not collect tax? ................................................. r Yes rNo
If yes, is the fuel stored, used, or consumed in an airport that is identied on the NPIAS? ............................................................ r Yes rNo
If yes, provide a list of applicable locations: ________________________________________________________________________________
Sales and Use Tax
Comments
Exemption Change
Mail to: Taxation Division Phone: (573) 751-2836
P.O. Box 358 TTY: (800) 735-2966
Jefferson City, MO 65105-0358 Fax: (573) 522-1271
E-mail: salestaxexemptions@dor.mo.gov
Form 126 (Revised 11-2016)
*15600030001*
15600030001
rI would like to change from a transient employer to a regular employer.
(Must have led 24 consecutive months in Missouri)
Change* Withholding Tax Filing Frequency To:
rAnnually (less than $100 withholding tax per quarter)
rQuarterly ($100 withholding tax per quarter to $499 per month)
rMonthly ($500 to $9,000 withholding tax per month)
rQuarter-Monthly (weekly) (over $9,000 withholding tax per month,
required to pay electronically)
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Missouri DOR - Form 126 Registration or Exemption Change Request

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Completed 26 May 2020

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