Form 943 - Request For Tax Clearance Page 2
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2Complete this page and attach to form if Reason for Request on page 1 is #2 Office of Administration Contract Bid greater than
$1,000,000 or #4. All applicable identification numbers must be completed on page 1 in order to process your request.
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1. I am requesting a Vendor No Tax Due for a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Bid
Contract
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2. Is the bid or contract for a
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Individual
Business
1. Name of agency or university that the bid or contract is with. _______________________________________________________________
_______________________________________________________________________________________________________________
2. What service(s) or item(s) will be supplied in the bid or contract? ____________________________________________________________
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3. Does the business or individual make taxable sales to Missouri customers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
4. Does the business or individual have any affiliates (any person or entity that is controlled or under common
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control with the vendor) in the state of Missouri? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If yes, please list the FEIN(s) and Missouri Tax Identification Number(s). Attach a second sheet if needed. ___________________________
_______________________________________________________________________________________________________________
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5. Do any of the affiliates make taxable sales? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
N/A
*15012020001*
15012020001
Form 943 (Revised 04-2015)
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Parent category: Financial