Candidate’s Affidavit of Tax Payments (Form 5120)

If you desire to file as a candidate for election to a public office in Missouri, you must file a Candidate’s Affidavit of Tax Payments (Form 5120) with the Missouri Department of Revenue in addition to other required documents filed to the Secretary of State or local election official.

In the Affidavit, you will state that you are not delinquent in the payment of any state income taxes, personal property taxes, real property taxes on your place of residence as stated on the declaration of candidacy, and that you are not a past or present corporate officer of any motor vehicle and driver license office that owes any taxes to the state.

You must complete all information requested on the Affidavit, sign the Affidavit before a notary, and have the Affidavit notarized. The original Affidavit must be filed with the Missouri Department of Revenue. A copy of the Affidavit must be attached to your declaration of candidacy filed with the Adair County Clerk.

Click here for Form 5120


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