Missouri Farmer's Cooperative Credit Associations Intangible Property Tax Return

Farmer's Cooperative Credit Associations Intangible Property Tax Return
Form INT-5 - 2023 Farmers’ Cooperative Credit Associations Intangible Property Tax Return
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r Amended Return - Select if filing an amended return.
Form

2023 Farmers’ Cooperative Credit Associations
Intangible Property Tax Return

INT-5

r Federal Extension - Select this box if you have an
	
	

approved federal extension.

2024 Taxable year based on the 2023 calendar year income period	

Due date April 15, 2024

Name

Address

City	

State	

Federal Employer Identification Number (FEIN)	

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ZIP Code

County Name	

County Code

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	 1.	 Gross income derived from all sources during 2023............................................................................... 	1

Part 1 - Computation of Tax

	 2.	 Gross income derived from notes and mortgages.................................................................................. 	2
	 3.	 Ratio of Line 2 to Line 1.......................................................................................................................... 	3

%

	 4.	 Total dividends declared and credited (whether paid or not) to share accounts of members in 2023.... 	4
	 5.	 Taxable portion of dividends (______________ % Line 3 multiplied by Line 4)..................................... 	5
	 6.	 Amount of tax (2% of Line 5)................................................................................................................... 	6
		 6A. Miscellaneous credits (attach schedule)........................................................................................... 	6A
		 6B. Enterprise Zone Credit...................................................................................................................... 	6B
		 6C. Missouri tax - Line 6 less Lines 6A and 6B....................................................................................... 	6C
	 7.	 Interest for delinquent payment after April 15, 2024............................................................................... 	7

Part 2 - Political Subdivisions Taxing The Reporting Association

	 8.	 Total Amount Due................................................................................................................................... 	8

This must be completed — Information is shown on your Real or Personal Property Tax Receipt
Subdivisions

Name or Number

County
City or Town
Road District
School District
Library District
Water District
Sewer District
Fire District
Other Districts

Form-INT-5 (Revised 12-2023)

This return is to be filed by all Farmers’ Cooperative Credit Associations authorized to do business in Missouri.
State of Missouri

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Part 3 - Attestation

County Of ____________________________

We, the undersigned ____________________________________________________________________, as President, and

_______________________________________________ , as Secretary of _______________________________________
Association, a corporation organized under an Act of Congress known as the Farm Credit Act of 1933 with its principal office
at ______________, Missouri, attest the statements made in the 2023 Farmers’ Cooperative Credit Associations Intangible
Property Tax Return are true; that the principal business of said Association during 2023 was the extension of agricultural credit
to its members; that said Association, by authority of a resolution of its Board of Directors, has elected to absorb and pay these
taxes without charging the same to the accounts of its individual members.
Signature of President

Authorization and Signature

Signature of Secretary

I authorize the Director of Revenue or delegate to discuss my return and attachments with the preparer or any
member of his or her firm, or if internally prepared, any member of the internal staff......................................................... 	

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Yes

r No

Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct.
Declaration of preparer (other than taxpayer) is based on all information of which he or she has any knowledge.
Signature of Officer (Required)	

Title of Officer	

Phone Number	

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Date (MM/DD/YYYY)

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Preparer’s Signature (Including Internal Preparer)	 Preparer’s FEIN, SSN, or PTIN	 Phone Number	

Date (MM/DD/YYYY)

		(___ ___ ___)___ ___ ___-___ ___ ___ ___	 __ __ /__ __ /__ __ __ __
Email Address

Make check or money order payable to “Missouri Department of Revenue”. Mail completed form and attachments to the address below.
If you pay by check, you authorize the Department of Revenue to process the check electronically. Any returned check may be presented
again electronically.

Form INT-5 (Revised 12-2023)

Mail to:	 Taxation Division

E-mail: [email protected]

	
	

Visit dor.mo.gov/taxation/business/tax-types/finance/ for additional information.

P.O. Box 898
Jefferson City, MO 65105-0898

Phone: (573) 751-2326
Fax: (573) 522-1720
TTY: (800) 735-2966

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