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Local Tax Refund Request
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Claimant's Name
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City Account Number (if applicable)
Mailing Address Street
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ZIP Code
*
Contact Name
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Type of Refund
*
Choose One
Sales Tax
Consumer Use Tax
Building Use Tax
Lodging Tax
Amount of Refund Requested
*
Explanation of Claim
*
1. For your refund to be processed, supporting documents must be attached as picture (.tif or .jpg) or portable document format (.pdf) files.
2. Helpful items tell the story and may include receipts, invoices, returns, exemption licenses, permits or other helpful documents.
3. Contact us to find out what you need to send if you're not sure (303) 235-2820
Attach Supporting Documents
By imprinting my name below I declare under penalty of perjury that the statements made herein are true and correct to the best of my knowledge and reasonable belief.
Individual's Name
*
Individual's title or relationship to claimant
* indicates required fields.
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