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Get And Sign Missouri Form 4923 Motor Fuel Refund Claim

And take full responsiblity for the information thereon that I have made the purchases and used the motor fuel as shown above and paid the tax on the original invoices attached hereto that the invoice dates or extensions have not been changed and that no portion of such motor fuel listed on Line 25 has been or will be used on public roads of the state of Missouri and that I am entitled to the refund amount claimed. Title Printed Name Date MM/DD/YYYY / / Mail to Taxation Division P. O. Box 800...

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