Ia 843 Form PDF Details

The IA 843 form serves as a critical tool for taxpayers in Iowa seeking refunds for various state taxes, including sales, use, excise, and local option taxes. Functioning under the jurisdiction of the Iowa Department of Revenue, this form accommodates a wide array of refund claims. Detailed in its design, the document requires filers to provide comprehensive information about the nature of their claim, including specific sections for retail sales tax, vehicle one-time registration fees, fuel used for agricultural or manufacturing purposes, local option sales tax, and several other tax categories that might affect residents and businesses in the state. Importantly, the IA 843 form mandates the inclusion of supporting documentation for claims, such as invoices or exemption certificates, ensuring that the process maintains strict adherence to regulatory requirements. Furthermore, the form outlines clear instructions on who may file, the necessary signatures, and the appropriate steps for submission, including addresses and contact information for the Iowa Department of Revenue. By breaking down the claim period by quarters and providing spaces for detailed explanations of the refund request, this form represents a structured approach to tax refund claims within the state. It underscores Iowa's tax administration's commitment to comprehensive procedures while ensuring taxpayer accessibility for refund requests.

QuestionAnswer
Form NameIa 843 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesIowa, 10-BUCHANAN, 46-HUMBOLDT, 15-CASS

Form Preview Example

Iowa Department of Revenue

www.iowa.gov/tax

IA 843 Claim for Refund

 

Sales, Use, Excise, and Local Option Tax

FOR OFFICE USE ONLY

 

 

 

 

 

 

 

 

 

NAME

 

DLN

 

 

 

 

 

 

 

 

BUSINESS NAME

 

CONTROL NUMBER

 

 

 

 

 

 

CURRENT MAILING ADDRESS

 

TOTAL REFUND

 

 

 

 

 

 

 

CITY, STATE, ZIP

500#

 

EXAM DATE

DUP

 

 

 

 

 

 

SOCIAL SECURITY NUMBER

SALES OR USE TAX PERMIT NUMBER

COMMENTS

FEDERAL EMPLOYER IDENTIFICATION NUMBER

COUNTY NUMBER

CHECK THE BOX corresponding to the type of refund you are claiming. Complete all sections on the form. See instructions for documentation required to support claim.

 

 

Retail Sales Tax

 

 

Vehicle One-time Registration Fee/Vehicle Use Tax:

 

 

 

 

 

Fuel Used in Implement of Husbandry

 

 

 

 

Enter your Vehicle Identification Number (VIN):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fuel Used in Processing

 

 

Local Option Sales Tax: Complete the schedule on the second page.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Local Hotel / Motel Tax

 

 

 

 

 

 

 

 

Machinery, Equipment, and Computers

 

 

 

 

 

 

 

 

 

 

 

 

 

Automobile Rental Tax

 

 

 

 

 

 

Retailer’s Use Tax

 

 

 

 

 

 

 

 

 

 

 

 

State Excise Tax:

 

Lodging

 

Certain Construction Equipment

 

 

Consumer’s Use Tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Biodiesel Production

CLAIM PERIOD ______________ TO _____________ Break down claim period by quarters. Attach additional sheets if necessary.

TAX PERIOD

ORIGINAL IOWA TAX PAID (no local option sales tax)

CORRECTED AMOUNT

TAX TO BE REFUNDED

1.SUBTOTALS:

2.Subtotals: Combined School and Regular Local Option Tax Refund from reverse side

3.TOTAL REFUND DUE: Add subtotals.

REASON FOR REFUND REQUEST: Explain in detail the reason(s) a refund is due, including applicable Code section and rule references. Attach an additional sheet if needed. __________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

ATTACH ALL SUPPORTING DOCUMENTATION AS REQUIRED. SEE INSTRUCTIONS.

I, the undersigned, declare under penalty of perjury that I have examined this claim, including all accompanying schedules, documentation, and statements, and, to the best of my knowledge and belief, it is a true, correct, and complete claim.

CLAIMANT’S SIGNATURE: _________________________________ DATE: ______________ PHONE NUMBER: __________________________

PRINT NAME: ___________________________________________ TITLE (IF CORPORATION): _______________________________________

22-009a (09/28/11)

Computation of Local Option Sales Tax

Claim Period

 

to

Break down the claim period by quarters. Attach an additional sheet if needed. Break down each tax period by county and each type of local option sales tax. Combine the total of each type local option tax on the Total Combined line. Record the information on the front of this claim on line 2, Subtotals: Combined School and Regular Local Option Tax Refund.

TAX

COUNTY

ORIGINAL

CORRECTED

LOCAL OPTION TAX

SCHOOL LOCAL OPTION

PERIOD

NUMBER

TAX PAID

AMOUNT

TO BE REFUNDED

TAX TO BE REFUNDED

 

 

 

 

 

(for period prior to 7-1-08 only)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTALS

Total Combined Local Option Tax Due. Enter on line 2 of page 1, Subtotals.

Instructions for IA 843

If this is a correction to a sales tax return, you need to file an amended return.

Who May File

Farm and Industrial Machinery and Equipment: Copies of

Any taxpayer who believes that an overpayment of retail sales,

the invoices. Explain how each item is used directly and

retailer’s use, consumer’s use, vehicle one-time registration fee/

primarily in your agricultural production or manufacturing

use tax, local option, local hotel/motel, automobile rental, or

process.

state excise tax exists may file this Claim for Refund form.

Computers: Copies of all invoices. Explain how they are used

The IA 843 may not be used to claim a refund of withholding.

in processing or storing data and describe your type of business

Employers must file an amended withholding quarterly return to

or occupation.

claim a withholding tax refund.

Vehicle One-time Registration Fee (on or after 7-1-08) /

Individuals must file the IA 1040, IA 1040A, or IA 1040X, as

Vehicle Use Tax (prior to 7-1-08): Copies of the original bill

appropriate, to request a refund of Iowa income tax withheld.

of sale, the title, and any additional supporting information.

All claims must include a sales or use tax permit number, if

NOTE: The vehicle identification number (VIN) must be

entered on the first page of this claim form.

applicable.

Local Option Tax: Copies of all invoices verifying that local

Individuals: You must provide your Social Security Number.

option tax has been paid to the State of Iowa.

Sole Proprietors: You must provide a Social Security Number

Biodiesel Production: Provide the number of biodiesel

and a Federal Employer Identification Number, if applicable.

Partnerships and Corporations: You must provide your

gallons produced during each quarter.

Where to File: Compliance Division

Federal Employer Identification Number.

Who Must Sign

Iowa Department of Revenue

PO Box 10456

If a claim is filed for a corporation, the claim must be signed

Des Moines, IA 50306-0456

either by an officer or other authorized representative of the

Where is My Sales/Use Refund? Call 515/242-6034.

corporation. If an attorney or agent is filing the claim on behalf

of the claimant, a power of attorney (original) authorizing the

Questions?

attorney or agent to sign must be submitted with the claim. A

·Phone: 515-281-3114 or 1-800-367-3388

power of attorney should clearly identify who is to receive the

refund check and where it should be mailed.

· E-mail: idr@iowa.gov

IOWA COUNTIES AND COUNTY NUMBERS

 

Supporting Documentation Required

Retail Sales/Use Tax, Consumer’s Use Tax, Local Hotel/ Motel, State Excise, and Automobile Rental Tax: Provide copies of the invoices, exemption certificates, credit memos, and any other supporting documentation applicable.

Fuel Used in Processing and Implements of Husbandry: A processing vs. nonprocessing energy study to determine the exempt percentage, copies of all invoices, and a schedule of energy used. Explain the manufacturing process (how the equipment using the fuel is used in this process) and describe the tangible personal property to be sold at retail.

01-ADAIR

26-DAVIS

51-JEFFERSON

76-POCAHONTAS

02-ADAMS

27-DECATUR

52-JOHNSON

77-POLK

03-ALLAMAKEE

28-DELAWARE

53-JONES

78-POTTAWATTAMIE

04-APPANOOSE

29-DES MOINES

54-KEOKUK

79-POWESHIEK

05-AUDUBON

30-DICKINSON

55-KOSSUTH

80-RINGGOLD

06-BENTON

31-DUBUQUE

56-LEE

81-SAC

07-BLACK HAWK

32-EMMET

57-LINN

82-SCOTT

08-BOONE

33-FAYETTE

58-LOUISA

83-SHELBY

09-BREMER

34-FLOYD

59-LUCAS

84-SIOUX

10-BUCHANAN

35-FRANKLIN

60-LYON

85-STORY

11-BUENA VISTA

36-FREMONT

61-MADISON

86-TAMA

12-BUTLER

37-GREENE

62-MAHASKA

87-TAYLOR

13-CALHOUN

38-GRUNDY

63-MARION

88-UNION

14-CARROLL

39-GUTHRIE

64-MARSHALL

89-VAN BUREN

15-CASS

40-HAMILTON

65-MILLS

90-WAPELLO

16-CEDAR

41-HANCOCK

66-MITCHELL

91-WARREN

17-CERRO GORDO

42-HARDIN

67-MONONA

92-WASHINGTON

18-CHEROKEE

43-HARRISON

68-MONROE

93-WAYNE

19-CHICKASAW

44-HENRY

69-MONTGOMERY

94-WEBSTER

20-CLARKE

45-HOWARD

70-MUSCATINE

95-WINNEBAGO

21-CLAY

46-HUMBOLDT

71-O’BRIEN

96-WINNESHIEK

22-CLAYTON

47-IDA

72-OSCEOLA

97-WOODBURY

23-CLINTON

48-IOWA

73-PAGE

98-WORTH

24-CRAWFORD

49-JACKSON

74-PALO ALTO

99-WRIGHT

25-DALLAS

50-JASPER

75-PLYMOUTH

 

22-009b (04/13/12)

How to Edit Ia 843 Form Online for Free

When you desire to fill out 62-MAHASKA, you don't have to install any applications - simply make use of our online PDF editor. To make our editor better and easier to work with, we continuously work on new features, bearing in mind feedback from our users. With some easy steps, you can start your PDF journey:

Step 1: Access the PDF form in our tool by pressing the "Get Form Button" in the top section of this webpage.

Step 2: The editor provides the capability to customize PDF files in a variety of ways. Transform it with personalized text, correct original content, and include a signature - all within the reach of a few clicks!

With regards to the blanks of this precise document, here is what you want to do:

1. You need to fill out the 62-MAHASKA accurately, thus be careful when filling in the segments containing all these blank fields:

Stage # 1 in submitting SUBTOTALS

2. Right after finishing this section, head on to the subsequent step and complete the essential details in these blanks - Consumers Use Tax, Automobile Rental Tax State Excise, Lodging, Biodiesel Production, Certain Construction Equipment, CLAIM PERIOD TO Break down claim, TAX PERIOD, ORIGINAL IOWA TAX PAID no local, CORRECTED AMOUNT, TAX TO BE REFUNDED, SUBTOTALS, Subtotals Combined School and, TOTAL REFUND DUE Add subtotals, and REASON FOR REFUND REQUEST Explain.

Filling in part 2 of SUBTOTALS

It's easy to make an error while filling in the Certain Construction Equipment, therefore you'll want to take a second look before you decide to send it in.

3. This part is generally hassle-free - fill out all the blanks in I the undersigned declare under, CLAIMANTS SIGNATURE DATE PHONE, and PRINT NAME TITLE IF CORPORATION to complete this segment.

Completing segment 3 in SUBTOTALS

4. To go forward, this fourth step requires typing in a handful of empty form fields. These comprise of Computation of Local Option Sales, Break down the claim period by, TAX, PERIOD, COUNTY NUMBER, ORIGINAL TAX PAID, CORRECTED, AMOUNT, LOCAL OPTION TAX TO BE REFUNDED, SCHOOL LOCAL OPTION TAX TO BE, TOTALS, Total Combined Local Option Tax, Instructions for IA, If this is a correction to a sales, and Farm and Industrial Machinery and, which you'll find crucial to moving forward with this document.

SUBTOTALS conclusion process detailed (part 4)

Step 3: Reread all the information you've entered into the blank fields and then click on the "Done" button. Sign up with us today and easily use 62-MAHASKA, all set for downloading. All modifications you make are preserved , allowing you to edit the document later on as needed. FormsPal is devoted to the confidentiality of our users; we make sure that all personal information entered into our editor stays secure.

Ia 843 Form isn’t the one you’re looking for?

Related Documents