Washington Application for Refund or Credit

Application for Refund or Credit
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Department of Revenue
Application for Refund or Credit
Important: Applications not fully completed or received without supporting documentation will not be accepted.
Account ID

Period covered by Claim

Total Refund Claimed

Name of Claimant
Address

Telephone Number

City

State

Zip Code

Name of Representative (attach a Confidential Tax Information Authorization form if filing on behalf of claimant)
Address

Telephone Number

City

State

Zip Code

Provide a full explanation on which your claim is based. Use additional sheets if necessary and send all
documents necessary to properly substantiate your claim.

Subject to penalty of perjury, I declare that the information provided is true, correct and complete. I do hereby
make application for refund or credit, pursuant to RCW 82.32.060, and certify that all taxes for which this claim
is filed have been paid.

Claimant’s or Representative’s Signature

Date

Print This Form
Name and Title (print)

Mail this application with supporting documentation to:

Attn: Refunds
State of Washington Department of Revenue
PO Box 47476
Olympia, WA 98504-7476

For tax assistance or to request this document in an alternate format, visit http://dor.wa.gov or call 360-705-6705. Teletype (TTY) users may use the Washington
State Relay Service by calling 711.
REV 41 0105e (4/13/20)

Instructions for Completing the Application for Refund or Credit Form
1. Who should file this form?
A seller who is claiming a refund or credit to their
account for overpaid taxes, penalties, or interest.
A buyer that has paid retail sales tax in error and one of
the following conditions exists:
 The seller is no longer engaged in business.
 The seller has moved or the buyer cannot
locate the seller.
 The seller is insolvent and is financially unable
to make the refund.
 The seller refuses to refund the retail sales tax
directly to the buyer, but agrees it should not
have been collected.
2. What information needs to be included on the
Application form?
All applicable sections must be fully completed or the
application will not be accepted. If a claim is being
filed that involves more than one account ID, then a
separate application must be filed for each account.
The claim must include the following information:
 Taxpayer's name and account ID number
 Total refund amount being claimed
 Tax classifications and periods being
affected
 Basis for the claim
 Signature of taxpayer or representative
3. What documentation needs to be attached to
the form to support this claim?
RCW 82.32A.030 requires taxpayers to substantiate
refund claims. Supporting documentation may
include the following items:
 Invoices
 Resale certificates
 Sales tax exemption certificates
 Proof that sales tax has been paid
 Proof of refund or credit to customer
 Detail of bad debts
 Contracts and other sales documents
4. When does the Seller’s Declaration need to be
attached?
The Seller’s Declaration form must be attached
when the buyer is filing the claim, has paid retail
sales tax in error, and has obtained a signed Seller’s
Declaration affirming the seller will not refund or
credit the sales tax directly back to the buyer.

REV 41 0105e (4/13/20)

5. When does the Buyer’s Declaration need to be
attached?
The Buyer’s Declaration form must be attached
when the buyer is filing the claim, has paid retail
sales tax in error, but is unable to obtain a signed
Seller’s Declaration.
6. What will happen if this form is not fully
completed or if supporting documentation is
not attached?
You will be notified that your Application for
Credit or Refund was not accepted.
7. What tax periods can be included within the
claim?
RCW 82.32.060 provides that a refund or credit cannot
be made for taxes, penalty, or interest paid more than
four years prior to the beginning of the calendar year in
which the refund application is made, unless a valid
written waiver has been executed.
8. What if the records to substantiate my claim
contain too many pages to attach them all?
Provide a detailed spreadsheet containing the
transaction information supporting your claim. When
possible, submit the information electronically using
Secure Messaging from the Department’s website at
dor.wa.gov
9. What if my company is currently under an
audit conducted by the Department of
Revenue?
Present the completed application and required
documentation directly to the Revenue Auditor.
10. What if I have questions about my claim?
Question about the form: Call the Department of
Revenue by phone at 360-705-6705, or send an email
inquiry to [email protected]
Questions about a claim: Dial 360-705-6215
11. Where do I mail this form and supporting
documents once they are completed?
Please mail your claim to the following address:
Attn: Refunds
Washington State Department of Revenue
PO Box 47476
Olympia, WA 98504-7476