Form 4679 – Motor Vehicle Sales or Use Tax Protest Payment Affidavit (Fillable PDF)

Form 4679 is the official Motor Vehicle Sales or Use Tax Protest Payment Affidavit required by the Missouri Department of Revenue. Taxpayers who dispute a motor‑vehicle sales or use tax assessment use this form to submit a protest payment in accordance with Sales Tax Regulation 12 CSR 10‑3.552 or Section 144.700, RSMo.

What Is Form 4679?

The form collects:

• Vehicle identification details (VIN, make, model, year)
• Seller and buyer information
• The amount of tax being protested
• A sworn statement that the protest payment is being made

When filed correctly, the protest payment is held while the dispute is reviewed. If the form is incomplete, the payment may be sent to the state’s general revenue fund.

How to Complete the Fillable PDF on Formize

Instead of downloading, printing, and scanning, you can fill the form directly in your browser:

1. Click the "Fill out this form" button on this page.
2. Wait a few seconds while the Formize PDF Filler app loads.
3. Enter the requested information in each highlighted field.
4. Use the built‑in signature tool to add your electronic signature.
5. When you’re satisfied, click Save & Download to get a completed PDF.
6. Print the final PDF (if required) and submit it according to the instructions below.

Common Mistakes to Avoid

• Leaving fields blank: Every field marked with an asterisk (*) is mandatory.
• Incorrect VIN: Double‑check the vehicle identification number; a typo can delay processing.
• Wrong payment amount: Use the exact amount shown on your tax notice.
• Missing signature: The electronic signature must be applied before saving.

Where to Submit the Completed Form

Mail the signed PDF to:

Missouri Department of Revenue
Taxpayer Services – Tax Protest Unit
P.O. Box 577
Jefferson City, MO 65105

Or deliver it in person to any Missouri Department of Revenue office. Keep a copy for your records.

Need More Help?

Visit the official Form 4679 page for the printable version and additional guidance. The Formize filler handles all field validation, so you can be confident your protest meets state requirements.