Step 1. Idenfy Your Business
Business name Minnesota Tax ID number
Mailing address Audit period
From Through
City State ZIP code
Main business address in Minnesota (if dierent from above)
City State ZIP code
Name of person to contact about this request Title Phone Email
Refund amount you are requesng:
Minnesota state sales tax of $ plus local taxes of $ . Total refund requested: $
Date audit was paid Was the audit assessment paid in full? Yes No
Step 1
Use this form to request a refund of Minnesota sales, use, and/or local taxes assessed on a sales and use tax audit that has been paid
in full. You must le the request within 3 and one half years from the date the tax was due, or one year from the date of an order as-
sessing tax, whichever is later.
You must aach the Minnesota Department of Revenue Tax Order, Form ST310C, Explanaon of Adjustments, and all audit schedules
and exhibits.
ST11-AUD
Request for Tax Paid on Periods Audited for Sales and Use Taxes
(5/17)
Aach all required documentaon and mail to:
Minnesota Revenue, 525 Lake Avenue South, Suite 405, Duluth, MN 55802
Or email this request and documentaon to: salesuse.claim@state.mn.us
Signature
I declare that this form and supporng documentaon is correct and complete to the best of my knowledge and belief. A
request for refund led by a corporaon must bear the original signatures and tles of the ocers having the authority to
sign for the corporaon.
Signature of taxpayer or authorized representave Title Date Phone
Check here if Form REV184, Power of Aorney, is aached.
Step 2
Step 2. Reason For This Request
Check the appropriate box below to indicate the reason for this request. You must provide documentaon that was not present at the
me of the audit to support your request. We may ask for addional documentaon to process this request. If you fail to provide com-
plete documentaon, your request may be denied.
Sales
The sales were not taxable. Provide fully completed exempon cercate(s) received from the purchaser.
The sales were taxable. However, use tax was self-assessed and paid directly to the department by the purchaser. Provide a signed
statement from the purchaser with purchase dates, amounts, tax periods in which the tax was paid and the purchaser’s Minnesota tax
ID number.
The sales were taxable. However, the purchaser was assessed use tax during an audit. Provide a signed statement from the purchaser
with the purchaser’s Minnesota tax ID number and the period covered by audit.
Other: Explain:
Purchases
Purchase invoices showing that sales tax was paid were discovered aer the me of the audit. Provide copies of invoices arranged in
date order.
Other: Explain:
