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Sales and Use VDA Fill-In Form

Request for Sales or Use Tax Voluntary Disclosure Agreement (VDA)

A taxpayer is not required to reveal its identity in order to request a VDA. A representative may submit an anonymous request on the taxpayer's behalf. Alternately, a taxpayer may initiate its own request and provide the company name and other information on the appropriate lines.

Please complete the following information (* Denotes a required field)

 Representative Information
* Representative Name
* Representative Address
* City
* State
* Zip Code
* Email Address
* Phone Number
Fax Number
 Company Information
Company Name
Company Address
Zip Code
Email Address
Phone Number
Fax Number
 Additional Questions
* Type of VDA requested (check all that apply)
 Sales Tax
 Consumer's Use Tax
 Seller's Use Tax (out-of-state sellers only)
* Type of products or services sold in Ohio
* Method of marketing products or services in Ohio
* Any other nexus-creating activities in Ohio
* Date activities began in Ohio
* Has sales tax been collected?

If already registered for sales or use tax, provide registration number
Estimated sales tax liability
Estimated use tax liability
* Do you have a direct pay or have you held a direct pay within the last 4 years?

If so, do you have an ability make a claim (or have made a claim) against the State of Ohio based on amounts erroneously paid to your vendors? *The Department is not concerned about valid use based exemptions.

* Has the company been contacted by the Ohio Department of Taxation regarding a sales or use tax audit, enforcement action or otherwise?

If yes, please describe nature of contact by the department
* Please Type Your Signature
Type the number:

Additional Resources

Additional Resources