Complete and submit this voucher if the status of your
business or sales and use tax location has changed.
Missouri Tax I.D. Number
Business Name
Owner’s Name
Date Account or Location Closed (MM/DD/YYYY)
Complete This Section If Closing Only One Sales and Use Tax Location
Physical Business Address Or Item Tax Of the Location You are Closing
__ __ /__ __ /__ __ __ __
Reason For Closing (select all that apply)
r Out of Business r Sold r No Employees
r Other (Explain) _______________________________________________
Tax Type Closing (Select all that apply)
rSales and Use Tax rEmployer Withholding Tax
If you led a nal return, paid all taxes, penalties and interest due, and have a
transient employer or sales and use tax cash bond or certicate of deposit on
le, you may request a return of the bond by completing the following.
Amount of Bond
$
Return Bond To:
Name Title
Address City State ZIP Code
Signature Telephone Number
(__ __ __) __ __ __ - __ __ __ __
Mail To: Taxation Division
PO Box 3300
Jefferson City, MO 65105-3300
*15505010001*
15505010001
Bond Refund
Missouri Department of Revenue
Final Report
Form
5633
Form 5633 (Revised 08-2015)
