Form 332 Cash Bond

User Manual: 332

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Form

332

Department Use Only
(MM/DD/YY)

Missouri Department of Revenue
Cash Bond

Missouri Tax I.D.
Number
(Optional)

Print Form

Federal Employer
I.D. Number

Personal or company checks will not be accepted as payment. Please remit a cashiers check or money order.
Cash Bond Type

Select only one:

r Sales and Use Tax		
r Motor Fuel Tax
r Other Tobacco Products 			 Motor Fuel license type (Select One):
r Cigarette Tax			 r Supplier or Permissive Supplier	r Distributor
r Transient Employer Withholding and Unemployment Tax		 r Terminal Operator
r Transporter

Amount (U.S. Currency - No personal or company checks)		

Date (MM/DD/YYYY)

$

__ __ / __ __ / __ __ __ __

At the request of Taxpayers or Business (Owner’s name, all Partners, Corporation, or LLC Name)
Taxpayer or Business Owner’s Address

		

City

County

State

E-mail Address

Zip Code

_ _______________________________________________________________(Taxpayer) hereby files with the
_
Missouri Department of Revenue this cash bond and the attached cashier’s check or money order in the amount of
___________________________________________________________________ ($___________________________).
Taxpayer understands that it is required to comply with all the provisions of any statutorily or constitutionally authorized state
or local tax.
If Taxpayer becomes delinquent and owes the Department the above indicated tax, related fees, interest, additions to tax,
and penalties due the state of Missouri, the Director of Revenue may forfeit this bond and apply it to any unpaid
delinquencies.
Delivery of any demands, notice, or service of process by the Department shall be deemed sufficient and made in the
state of Missouri if personally served or if mailed by U.S. mail to the taxpayer or business address as set forth above.
This cash bond and any legal action pertaining thereto shall be governed by and construed in accordance with the laws of
the state of Missouri. The parties understand and agree that the exclusive jurisdiction for any action concerning this bond
shall be the state of Missouri and the only venue shall be in the Circuit Court of Cole County, Missouri.

Sign

By signing this cash bond, the undersigned states that he or she has authority to bind the taxpayer or business identified
herein.
No digital signatures allowed
Owner, Partner, Corporate Officer or LLC Member

Date (MM/DD/YYYY)

__ __ / __ __ / __ __ __ __
Form 332 (Revised 02-2015)

Mail to:
Sales and Use or Transient Employer
Withholding
Taxation Division
P.O. Box 357
Jefferson City, MO 65105-0357
Phone: (573) 751-5860
Fax: (573) 522-1722
E-mail: businesstaxregister@dor.mo.gov

Motor Fuel Tax
Taxation Division
P.O. Box 300
Jefferson City MO 65105-0300
Phone: (573) 751-2611
Fax: (573) 522-1720
E-mail: excise@dor.mo.gov

Cigarette Tax
Taxation Division
P.O. Box 811
Jefferson City MO 65105-0811
Phone: (573) 751-7163
Fax: (573) 522-1720
E-mail: excise@dor.mo.gov

Visit http://dor.mo.gov/business/register/ for additional information. TTY (800) 735-2966

*14602010001*
14602010001

Other Tobacco Products
Taxation Division
P.O. Box 3320
Jefferson City, MO 65105-3320
Phone: (573) 751-5772
Fax: (573) 522-1720
E-mail: excise@dor.mo.gov
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