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Click ‘Get Form’ to open it in the editor.
Begin by entering your Daytime Telephone Number and FEIN or SSN in the designated fields at the top of the form.
In Column A, provide the name and address of the individual or business to whom payment was made. Ensure this information is accurate for proper reporting.
In Column B, input the Federal Employer Identification Number (FEIN) or Social Security Number (SSN) for each payee listed.
Select and enter the appropriate code number from the provided list in Column C that best describes the payment type.
In Column D, indicate the total amount paid to each payee, ensuring all figures are correct.
Finally, in Column E, specify the amount or percentage of work performed within the City of St. Louis.
Complete your submission by dating, signing, and printing your name in the spaces provided at the bottom of the form.
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Form E - Application for General Permit Under Missouri Clean
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