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Get Ut Tc-55a 2005

VIN/HIN State City Zip code Daytime Telephone no. 1. Amount of sales tax or license fees paid $ 2. Correct amount of sales tax or license fee as computed by taxpayer $ 3. Amount claimed as a refund (subtract amount on line 1 from line 2) $ I believe that this claim should be allowed for the following reasons: (use reverse side if needed) Under penalties of perjury, I declare that I have examined this claim and to the best of my knowledge and belief it is true, correct and complete. Si.

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