Free DR-1 - Florida

ApplicAtion to collect And/or report tAx in FloridA

DR-1 R. 01/06

Who must apply?
Use tax
Complete Sections A, B, and H NO fee

You may be required to register to collect, accrue, and remit the taxes or fees listed below if you are engaged in any of the activities listed beneath each tax or fee.
Sales tax
Complete Sections A, B, and H Pay $5 fee (in-state only)*

·Sales,leases,orlicensestousecertain propertyorgoods(tangiblepersonal property). ·Salesandrentals/admissions,amusement machinereceipts,orvendingmachine receiptsforalltaxableitems. ·Repairoralterationoftangiblepersonal property. ·Leasesorlicensestousecommercialreal property(includesmanagementcompanies). ·Rentaloftransient(sixmonthsorless) livingorsleepingaccommodations (includesmanagementcompanies).Alocal touristdevelopmenttax(bedtax)mayalso apply.Contactthetaxingauthorityinthe countywherethepropertyislocated. ·Salesorrentalofself-propelled,powerdrawn,orpower-drivenfarmequipment. ·Salesofelectricpowerorenergy. ·Salesofprepaidtelephonecallingcards. ·Salesofcommercialpestcontrolservices, nonresidentialbuildingcleaningservices, commercial/residentialburglaryand securityservices,ordetectiveservices. ·Salesofsecondhandgoods.Asecondhand dealerregistration(FormDR-1S)mayalso berequired.
*Note: If you are registering an in-state business or property location, you must submit a $5 fee with this application. Online registration is free.

·Anytaxablepurchasesthatwerenottaxed bytheselleratthetimeofpurchase. ·Repeateduntaxedpurchasesthroughthe Internetorfromout-of-statevendors. ·Anypurchasesoriginallyforresale,but laterusedorconsumedbyyourbusinessor forpersonaluse. ·Useofdyeddieselfuelforoff-road purposes.

Register Online
It's FREE, fast, easy, and secure
You can file this application online, via the Department's Internet site at www.myflorida.com/dor/ eservices/apps/register. there is no fee for internet registration. See instructions, next page.

Unemployment tax
Complete Sections A, D, and H NO fee

documentary Stamp tax
Complete Sections A, F, and H NO fee

·Paidwagesof$1,500inanyquarteror employedatleastoneworkerfor20weeks inacalendaryear.(Paymentsmadeto corporateofficersarewages.) ·Applicantisagovernmentalentity,Indian tribeortribalunit. ·Holdasection501(c)(3)exemptionfrom federalincometaxandemployfourormore workersfor20weeksinacalendaryear. ·Agriculturalemployerwitha$10,000cash quarterlypayroll,orwhoemploysfiveor moreworkersfor20weeksinacalendar year. ·Privatehomeorcollegeclubthatpaid $1,000cashinaquarterfordomestic services. ·Acquiredallorpartoftheorganization, trade,business,orassetsofaliable employer. ·Liableforfederalunemploymenttaxes. ·Previouslyliableforunemploymenttaxin theStateofFlorida.

communications Services tax
Complete Sections A, G, and H NO fee

·Salesofcommunicationsservices (telephone,paging,certainfacsimile services,videoconferencing). ·Salesofcableservices. ·Salesofdirect-to-homesatelliteservices. ·Resellers(forexample,paytelephonesand prepaidcallingarrangements). ·Seekingadirectpaypermit.

Solid Waste Fees and pollutants tax
Complete Sections A, B, C, and H Pay $30 fee (drycleaning only)*

·Enteringintowrittenfinancingagreements (fiveormoretransactionspermonth). ·Makingtitleloans. ·Self-financingdealers(buyhere­pay here). ·Banks,mortgagecompanies,andconsumer financecompanies. ·Promissorynotes.

Gross receipts tax new for 2006
Complete Sections A, E, and H NO fee

·Salesordeliveryofelectricityorgas. ·Importation/severanceofelectricityor naturalgasforone'sownusewheregross receiptstaxhasnotbeenpaid.

·Salesofnewtiresformotorvehicles. ·Salesofneworremanufacturedlead-acid batteries. ·Rentalorleaseofmotorvehiclestoothers. ·Salesofdry-cleaningservices(plants ordrop-offfacilities).*Note: You must
submit a $30 fee with this application. Online registration is free.

How can I register online? TheDR-1applicationisontheDepartment'sweb siteat www.myflorida.com/dor/eservices/apps/ register.Aninteractivewizardwillguideyou throughanapplicationfromstarttofinish.Before youbegin,gatherspecificinformationaboutyour businessactivities,location,andbeginningdates. There are no fees for online registration. Salesandusetaxcertificatenumberswillbe issuedwithinthreebusinessdaysofyouronline submission.Afterthattime,youcanreturntothe siteandretrieveyourcertificatenumber. How can I be sure that the information I submit online is secure? TheDepartment'sInternetregistrationsiteuses 128-bitsecuresocketlayertechnologyandhasbeen certifiedbyVeriSign,anindustryleaderindata security. If a husband and wife jointly operate and own a business, what type of ownership must we indicate? Normally,whenahusbandandwifejointlyownand operateabusiness,theownershipisa"partnership." WesuggestyoucontacttheInternalRevenueService formoreinformationonpartnershipreporting requirements. What will I receive from the Department once I register? 1. ACertificate of Registrationornotificationof liabilityforthetax(es)forwhichyouregistered. 2. Personalizedreturnsorreportsforfiling,with instructions.

3. Foractivesalestaxandcommunicationsservices taxdealers,anAnnual Resale Certificatewill accompanytheCertificate of Registration. What is an Annual Resale Certificate? TheDepartmentissuesAnnual Resale Certificatesto active,registeredsalestaxdealersandcommunications servicestaxdealers.TheAnnual Resale Certificate allowsbusinessestomaketax-exemptpurchases fromtheirsuppliers,providedtheitemorserviceis purchasedforresale.AcopyofacurrentAnnual Resale Certificatemustbeextendedtothesupplier;otherwise, taxmustbepaidonthetransactionatthetimeof purchase.TaxInformationPublication(TIP)99A0134explainstheresaleprovisionsforsalesanduse tax.TIP01BER-01explainstheresaleprovisionsfor communicationsservicestax.ConsulttheDepartment's Internetsiteforfurtherinformation.Misuse of the Annual Resale Certificate will subject the user to penalties as provided by law. What are my responsibilities? 1. Youmustregisterforalltaxesforwhichyou areliablebeforebeginningbusinessactivities, otherwiseyoumaybesubjecttopenalties.For moreinformation,visitourInternetsiteorcontact TaxpayerServices. 2. CompleteandreturnthisapplicationtotheFlorida DepartmentofRevenuewiththeapplicable registrationfee.IFMAILING,DONOTSEND CASH.SENDCHECKORMONEYORDER. 3. Collectand/orreporttaxappropriately,maintain accuraterecords,postyourcertificate(ifrequired), andfilereturnsandreportstimely.A return/report must be filed even if no tax is due.

4. NotifytheDepartmentifyouraddresschanges, yourbusinessentityoractivitychanges,youopen additionallocations,oryoucloseyourbusiness. 5. Provideyourcertificateoraccountnumberonall returns,remittances,andcorrespondence. What if my business has more than one location? Sales tax:Youmustcompleteaseparateapplicationfor eachlocation.Gross receipts tax on electric power or gas:Youhavetheoptionofregisteringalllocations underoneaccountnumberorseparatelyregistering eachlocation.Documentary stamp tax:Youmust registereachlocationwherebooksandrecordsare maintained.Communications services tax and unemployment tax:Youmustregistereachentitythat hasitsownFederalEmployerIdentificationNumber (FEIN). Solid waste fees and pollutants tax (rental car surcharge):Youmustregisterforeachcountywhere youhavearentallocation. What if I am managing commercial or residential rental property for others? Forsalestax,commercialpropertymanagersmustuse thisapplication;residentialpropertymanagersmayuse FormDR-1C,Application for Collective Registration for Rental of Living or Sleeping Accommodations. ContactCentralRegistrationat850-488-9750for assistance. Are educational seminars offered? Yes.Togetascheduleofupcomingseminars ortoregisterforone,visitusonlineat www.myflorida.com/dororcalltheservicecenter nearestyou.
CT--Central Time ET--Eastern Time
Port Richey Service Center 6709 Ridge Rd Ste 300 Port Richey FL 34668-6842 727-841-4407 (ET) Sarasota Service Center Sarasota Main Plaza 1991 Main St Ste 240 Sarasota FL 34236-5940 941-361-6001 (ET) Tallahassee Service Center 2410 Allen Rd Tallahassee FL 32312-2603 850-488-9719 (ET) Tampa Service Center Ste 100 6302 E Martin Luther King Blvd Tampa FL 33619-1166 813-744-6344 (ET) West Palm Beach Service Center 2468 Metrocentre Blvd West Palm Beach FL 33407-3105 561-640-2800 (ET)

FloridA depArtment oF revenUe Service centerS
Alachua Service Center 14107 US Highway 441 Ste 100 Alachua FL 32615-6390 386-418-4444 (ET) Clearwater Service Center Arbor Shoreline Office Park 19337 US Highway 19 N Ste 200 Clearwater FL 33764-3149 727-538-7400 (ET) Cocoa Service Center 2428 Clearlake Rd Bldg M Cocoa FL 32922-5731 321-504-0950 (ET) Coral Springs Service Center Florida Sunrise Tower 3111 N University Dr Ste 501 Coral Springs FL 33065-5090 954-346-3000 (ET) Daytona Beach Service Center 1821 Business Park Blvd Daytona Beach FL 32114-1230 386-274-6600 (ET) Fort Myers Service Center 2295 Victoria Ave Ste 270 Fort Myers FL 33901-3871 239-338-2400 (ET) Fort Pierce Service Center Benton Building 337 N US Highway 1 Ste 207-B Fort Pierce FL 34950-4255 772-429-2900 (ET) Hollywood Service Center Taft Office Complex 6565 Taft St Ste 300 Hollywood FL 33024-4044 954-967-1000 (ET) Jacksonville Service Center 921 N Davis St A250 Jacksonville FL 32209-6829 904-359-6070 (ET) Key West Service Center 3118 Flagler Ave Key West FL 33040-4602 305-292-6725 (ET) Lake City Service Center 1401 W US Highway 90 Ste 100 Lake City FL 32055-6123 386-758-0420 (ET) Lakeland Service Center 230 S Florida Ave Ste 101 Lakeland FL 33801-4625 863-499-2260 (ET) Leesburg Service Center 1415 S 14th St Ste 103 Leesburg FL 34748-6686 352-315-4470 (ET) Maitland Service Center Ste 160 2301 Maitland Center Parkway Maitland FL 32751-4192 407-475-1200 (ET) Marianna Service Center 4230 Lafayette St Ste D Marianna FL 32446-8231 850-482-9518 (CT) Miami Service Center 8175 NW 12th St Ste 119 Miami FL 33126-1828 305-470-5001 (ET) Naples Service Center 3073 Horseshoe Dr S Ste 110 Naples FL 34104-6145 239-434-4858 (ET) Orlando Service Center AmSouth Bank Building 5401 S Kirkman Rd 5th Floor Orlando FL 32819-7911 407-903-7350 (ET) Panama City Service Center 703 W 15th St Ste A Panama City FL 32401-2238 850-872-4165 (CT) Pensacola Service Center 3670C N L St Pensacola FL 32505-5217 850-595-5170 (CT)

Account management 5050 W Tennessee St Tallahassee, FL 32399-0100 850-488-9750

taxpayer Services 800-352-3671 or 850-488-6800 tdd: 800-367-8331

Unemployment tax employer information center 800-482-8293

internet Site www.myflorida.com/dor tax law library www.myflorida.com/dor/law

Before returning application, remove this page and retain for future reference.

APPLICATION TO COLLECT AND/OR REPORT TAX IN FLORIDA
SECTION A -- BUSINESS INFORMATION


DR-1 R. 01/06 Page 1

1. This application is for (check all that apply):

Please use BLACK or BLUE ink ONLY and type or print clearly. Answer ALL questions in the section(s) that apply to your business.
2.

Tax Type

Fee Due

SalesandUseTax UseTaxOnly SolidWasteFeesandPollutantsTax UnemploymentTax GrossReceiptsTaxonElectricPowerandGas DocumentaryStampTax CommunicationsServicesTax

$5.00* Nofee $30.00** Nofee Nofee Nofee Nofee

A,B,H A,B,H A,B,C,H A,D,H A,E,H A,F,H A,G,H

Complete Sections

*The $5 registration fee does not apply if: Your business location is outside the State of Florida. Your business is moving from one Florida county to another. You register online.

· · ·

**The $30 registration fee applies to drycleaning only. There is no fee for online registration.

Indicatewhetherthisisanewregistration(neverbeforeregisteredwiththeFloridaDepartmentofRevenue)orachangetoanexistingregistration. New Registration Change to Existing Registration
A. Newbusiness entity B. Newbusiness location C. Newtaxobligation atexistinglocation D. Changeofcountylocation (Businessismovingfrom oneFloridacountytoanother) E. Changeof legalentity F. Changeof ownership



ProvidecertificatenumberifyoucheckedBorC:

­
Beginning date of business activity:

­

IfyouhavecheckedBoxD,E,orF,theDepartmentwillcancelyourexistingcertificate(s) andissueanewone.Providethecertificatenumber(s)tobecanceled. (Attachadditionalsheetifnecessary.)

­
year

­

month





day













If your business is relocating within the same county, do not use this application. Contact the Department to change your address. This change is effective (enter date):

ProvidethedatethisbusinesslocationorentitybecameorwillbecomeliableforFlorida tax(es).Donotuseyourincorporationdateunlessthatisthedateyourbusinessbecame liablefortax.If you have been in business longer than 30 days prior to registering, contact the DOR service center nearest you.



month





day







year





3.

Ifthisisaseasonalbusiness(notopenyear-round),listthemonthsofyouropenseason.
Beginningdate: month




day






year





Endingdate:


month




day






year


Owner telephone number:

** PLEASE TYPE OR PRINT CLEARLY **

4. Legal name of corporation, individual owner (last,first,middle) limited liability company, partnership, or other:

5. Trade or fictitious name (d/b/a) (ifdifferentthan#4above):

Business telephone number:

6. Complete physical address of business or real property.Home-basedbusinessesandnon-permanentfleamarket/craftshow vendorsmustusetheirhomeaddresses.Listingapostofficebox,privatemailbox,orruralroutenumberisnotpermitted.

Fax number:

City/State/ZIP:

County:

7. Mailing address (ifdifferentthanphysicaladdress):

Mailing address:

City/State/ZIP:

E-mail address:



8. IfyouhaveaConsolidated Sales Tax Numberandwanttoincludethisbusinesslocation,pleasecompletethefollowing: 8 0 ­ ConsolidatedregistrationnameonrecordwiththeFloridaDepartmentofRevenue. Consolidatedregistrationnumber
Ifyouwanttoobtainanewconsolidatednumber,contacttheDepartmentandrequestFormDR-1CON.



­

9. Business Entity Identification Number. Ifyouareregisteringforunemploymenttaxorhaveemployees,youmustprovideandFEIN.IfanFEIN isnotrequiredforyourbusinessentity,thesocialsecuritynumberoftheownerisrequired.SocialsecuritynumbersareusedbytheDepartmentas uniqueidentifiersfortheadministrationofFlorida'staxlaws.Theyareconfidentialundersections119.0721and213.053,FloridaStatutes,andare notsubjecttodisclosureaspublicrecords. a. b. FederalEmployerIdentificationNumber(FEIN): or SocialSecurityNumber(SSN)ofowner:



­


­




­











(IfyouarerequiredtohaveanFEIN,but havenotyetbeenassignedoneyoumay calltheInternalRevenueServiceat 800-829-4933torequestone.)

SECTION A -- BUSINESS INFORMATION (CONT'D.)
10. Identifyproprietorsorowners,partners,officers,members,ortrustees.Includethepersonwhosesocialsecuritynumberislistedunder Question9.Without this information, processing of your application may be stopped.
Social security number and Driver license number and state Home address City/State/ZIP Telephone number

DR-1 R. 01/06 Page 2

Name Title

(___)___-____ (___)___-____ (___)___-____ (___)___-____

11.

Type of ownership-Checktheboxnexttotheexactentitystructureofyourbusiness. Sole proprietorship-Anunincorporatedbusinessthatisowned byoneindividual. Partnership -Therelationshipexistingbetweentwoormore entitiesorindividualswhojointocarryonatradeorbusiness. Thisincludesabusinessjointlyowned/operatedbyahusband andwife. Checkone: Generalpartnership Limitedpartnership Jointventure Marriedcouple Corporation -Apersonorgroupofpeoplewhoincorporateby receivingacharterfromtheirstate'sSecretaryofState(includes professionalservicecorporations). Checkone: C-corporation S-corporation Not-for-profitcorporation Limited liability company-Twoormoreentities (orindividuals)whofilearticlesoforganizationwiththeir state'sSecretaryofState. Checkone: Single-memberLLC Multi-memberLLC Checkhereifyouelectedtobetreatedasacorporationfor federalincometaxpurposes.



Business trust-Anentitycreatedunderanagreementoftrust forthepurposeofconductingabusinessforprofit(includesreal estateinvestmenttrusts). Non-business trust/Fiduciary-Anentitycreatedbyagrantor forthespecificbenefitofadesignatedentityorindividual. Estate -Anentitythatiscreateduponthedeathofanindividual, consistingofthatindividual'srealorpersonalproperty. Dateofdeath:__________________ Government agency-Alegalgovernmentbodyformedby governingconstitutions,statutes,orrules. Indian tribe or Tribal unit-AnyIndiantribe,band,nation, orotherorganizedgrouporcommunitywhichisrecognizedas eligibleforthespecialprogramsandservicesprovidedbythe UnitedStatestoIndiansbecauseoftheirstatusasIndians(includesanysubdivision,subsidiary,orbusinessenterprisewholly ownedbysuchanIndiantribe).









12.


Ifapartnership,corporation,orlimitedliabilitycompany,provideyourfiscalyearendingdate:
month day

Note:
Ifnotincorporated,chartered orregisteredtodobusiness inFlorida,youmaybe requiredtodoso.Callthe FloridaDepartmentofState, DivisionofCorporations at850-488-9000formore information.

13.

14. 15.

Providethedateofincorporation,charter, Ifincorporated,charteredorotherwiseregisteredtodobusinessin Florida,provideyourdocument/registrationnumberfromtheFlorida orauthorizationtodobusinessinFlorida: SecretaryofState: _________________________________________________________ month day year Isyourbusinesslocationrentedfromanotherpersonorentity?Yes No Ifyes,andyoudo not operate from your home,providethefollowinginformation.

Ownerorlandlord'sname _________________________________________________________Telephonenumber _________________________ _ Address________________________________________________________________________City/State/ZIP_____________________________ a. Whatisyourprimarybusinessactivity? ____________________________________________________________________________________ b. Whatareyourtaxablebusinessactivities? __________________________________________________________________________________ c. Ifknown,enteryourNorthAmericanIndustryClassificationSystem(NAICS)Code: _______________________________________________ _ TodetermineyourNAICScode,gotohttp://www.naics.com/search.htm

SECTION B -- SALES AND USE TAX ACTIvITY -- $5 FEE (IN-STATE ONLY)
16. Doesyourbusinessactivityinclude(checkallthatapply): a. b. c. d. e. f. g. Salesofpropertyorgoodsatretail (toconsumers)? Salesofpropertyorgoodsat wholesale(toregistereddealers)? Salesofsecondhandgoods? Rentalofcommercialrealproperty toindividualsorbusinesses? Rentaloftransientlivingorsleeping accommodations(forsixmonthsor less)? Managementoftransientlivingor sleepingaccommodationsbelonging toothers? Rentalofequipmentorother propertyorgoodstoindividualsor businesses? h. i. j. k. Renting/leasingmotorvehiclesto others? Repairoralterationoftangible personalproperty? Chargingadmissionormembership fees? Placingandoperatingcoinoperatedamusementmachinesat businesslocationsbelongingto others? Placingandoperatingvending machinesatbusinesslocations belongingtoothers? Purchasingitemstobeincluded inafinishedproductassembledor manufacturedforsale? n.

DR-1 R. 01/06 Page 3

l. m.

Providinganyofthefollowingservices? (Checkallthatapply.) n1. Pestcontrolfornonresidentialbuildings n2. Cleaningservicesfornonresidential buildings n3. Detectiveservices n4. Protectionservices n5. Securityalarmsystemmonitoring o. Purchasingitemsthatwerenottaxedbythe sellerattimeofpurchase(includes,butisnot limitedto,purchasesthroughtheInternet, fromcatalogs,orfromout-of-statesellers)? p. Usingdyeddieselfuelforoff-roadpurposes? q. Operatingvendingmachine(s)ownedbyyou atyourbusinesslocation?

17.

Whatproductsorservicesdoyoupurchaseforresale?__________________________________________________________________________ _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________

COIN-OPERATED AMUSEMENT MACHINES 18. 19.


Are coin-operated amusement machines being operated at your business location? If yes, answer question 19. .......... Doyouhaveawrittenagreementthatrequiressomeoneotherthanyourselftoobtainamusementmachine certificatesforanyofthemachinesatyourlocation?Ifyes,providetheirinformationbelow..................................................

Yes Yes

No No

_____________________________________ _______________________________ __________________________ Name Address Telephonenumber
Note:YoumustcompleteanApplication for Amusement Machine Certificate(FormDR-18)ifyouansweredYEStoquestion18andNOtoquestion19.

CONTRACTORS 20. Do you improve real property as a contractor? If yes, answer questions 21-23. ................................................................ 21. Doyouselltangiblepersonalpropertyatretail?........................................................................................................................ . 22. DoyoupurchasematerialsorsuppliesfromvendorslocatedoutsideofFlorida?..................................................................... 23. Doyoufabricateormanufactureanybuildingcomponentatalocationotherthancontractsites?........................................... MOTOR FUEL 24. 25. 26. Do you sell any type of fuel or use off-road, dyed, diesel fuel? If yes, answer questions 25 and 26. ................................ a. Doyoumakeretailsalesofgasoline,dieselfuel,oraviationfuelatpostedretailprices?................................................... b. Ifyesto#25a,doesthisbusinessexistasamarina?............................................................................................................. c. Ifyesto#25a,doyouexpecttosellmoredieselfuelthangasoline?.................................................................................... d. Ifyesto#25a,provideyourFloridaDepartmentofEnvironmental Protectionfacilityidentificationnumberforthislocation. Doyouusedyeddieselfuelforoff-roadpurposesthatwasnottaxedatthetimeofpurchase?................................................ Yes Yes Yes Yes No No No No

Yes Yes Yes Yes

No No No No

Yes

No

SECTION C -- SOLID WASTE FEES AND POLLUTANTS TAX --
27. 28. 29. 30. 31. 32.

$30 FEE FOR DRYCLEANING ONLY

Do you sell tires or batteries, or rent/lease motor vehicles to others? If yes, answer questions 28-30. ............................. Doyoumakeretailsalesofnewtiresformotorizedvehicles(eitherseparatelyorasapartofavehicle)?.............................. Doyoumakeretailsalesofneworremanufacturedlead-acidbatteriessoldseparatelyorasacomponentpartof anotherproductsuchasnewautomobiles,golfcarts,boats,etc.?.............................................................................................. Areyouinthebusinessofrentingorleasingvehiclesthattransportfewerthanninepassengers toindividualsorbusinesses?....................................................................................................................................................... Do you own or operate a dry-cleaning dry drop-off facility or plant in Florida? ............................................................... If yes, enclose the $30 dry-cleaning registration fee. Do you produce or import perchloroethylene?....................................................................................................................... If yes, you must complete an Application for Florida License to Produce or Import Taxable Pollutants (Form DR-166).

Yes Yes Yes Yes Yes Yes

No No No No No No

SECTION D -- UNEMPLOYMENT TAX -- NO FEE

DR-1 R. 01/06 Page 4

If you are registering an additional business location and are already registered with the Florida Department of Revenue for unemployment tax, you do not need to complete this section. If you need to reactivate a previously assigned unemployment tax (UT) account number, enter your account number and complete items 33-41 below. Make sure that you have entered your FEIN on page 1, item 9. 33. Employertype(checkallthatapply):


Regular(Ifaleasingcompany,
attachcopyoflicense.)



Agricultural(citrus)




Governmentalentity




Nonprofitorganization

(501(c)(3)lettermustbeattached)

34. 35. 36. 37. 38. 39.

Domestic(household)

Agricultural(noncitrus)

Agriculturalcrewchief

Indiantribe/Tribalunit Yes No

Didyourbusinesspayfederalunemploymenttaxinanotherstateinthecurrentorpreviouscalendaryear?...........................

Ifyes,inwhichstate(s) _______________________________________________________________ Year(s)_________________________ Doyouleaseanyofyouremployees? Yes NoIfyes,checkwhetherallorpartofyourworkforceisleased:......... . All Part

LeasingCompanyName:__________________________________________ DBPRLicenseNumber: ___________________________________ _ Dateleasingbegan: ______________________________________________ LeasingCompany'sFEIN:_________________________________ LeasingCompany'sUTAcct.Number:_______________________________ Forthecurrentcalendaryear,howmanyfullorpartialweekshaveyouemployedworkers? _____________________________________________ Forthepreviousyear,howmanyfullorpartialweeksdidyouemployworkers? ______________________________________________________ ProvidethedatethatyoufirstemployedorwillemployworkersinFlorida. month day year Doesanotherparty(accountant,bookkeeper,agent)maintainyourpayroll?........................................................................... Ifyes,providethefollowinginformation. Nameofagent __________________________________________ Address_______________________________________________

Yes

No

Telephonenumber__________________________________ City/State/ZIP _________________________________________________

ProvideonlyyourFloridagrosspayrollbycalendarquarters.Estimateamountsifexactfiguresarenotavailable. Qtr Ending 3/31 Currentyear Previousyear Nextpreviousyear Nextpreviousyear Nextpreviousyear $ $ $ $ $ $ $ $ $ $ Qtr Ending 6/30 $ $ $ $ $ Qtr Ending 9/30 $ $ $ $ $ No Qtr Ending 12/31

40.

Didyoupurchasethisbusinessfromanotherentityorchangeyourcurrentbusinessstructureinanyway?........................... Yes Ifyes,completeitemsathroughibelow,providinginformationabouttheformerentity.Also,completeandsubmitaReport to Determine Succession and Application for Transfer of Experience Rating Records(FormUCS-1S)totheDepartmentofRevenue.Thisformmustbe postmarkedwithin90daysoftheacquisitiondatetobeconsideredtimely. b. FEIN______________________________________________

41.

a. Legalnameofformerentity_____________________________________________________________________________________________ c. UTaccountnumber __________________________________________ d. Tradename(d/b/a) ____________________________________________________________________________________________________ e. Address_____________________________________________________________________________________________________________ f. Dateofpurchase/change________________________________ g. Portionofbusinessacquired: Yes All Yes Part No Unknown h. Wasthebusinessinoperationatthetimethepurchase/changeoccurred? NoIfno,providedatebusinessclosed._____________

i. Wasthereanycommonownership,management,orcontrolatthetimethepurchase/changeoccurred?

List the locations and nature of business conducted in Florida. Use additional sheets if necessary. Address,city,andcountyofworksite Principalproducts/services Numberofemployees ________________________________________ _____________________________________________ ____________________________ ________________________________________ _____________________________________________ ____________________________ ________________________________________ _____________________________________________ ____________________________ Dotheaboveworksitesprovidesupportforanyotherunitsofthecompany?......................................................................... Yes No Ifyes,theservicesare: administrative research other,specify _________________________________________________________ ____________________________________________________________________________________________________________________

SECTION E -- GROSS RECEIPTS TAX -- NO FEE
42. 43. Do you sell, deliver, or transport electricity or gas? If yes, check the items below that apply:.......................................... a. Electricity............................................................................................................................................................................... b. Naturalormanufacturedgas?................................................................................................................................................ Doyouimportintothisstate,naturalormanufacturedgasforyourownuseasasubstituteforpurchasing taxableutilityortransportationservices?................................................................................................................................... . Yes Yes Yes Yes

DR-1 R. 01/06 Page 5

No No No No

SECTION F -- DOCUMENTARY STAMP TAX -- NO FEE
44. 45. 46. 47. Do you make sales, finalized by written agreements, that do not require recording by the Clerk of the Court, but do require documentary stamp tax to be paid? If yes, answer questions 45-47.......................... Doyouanticipatefiveormoretransactionssubjecttodocumentarystamptaxpermonth? ..................................................... . Doyouanticipateyouraveragemonthlydocumentarystamptaxremittancetobelessthan$80permonth?.......................... Yes Yes Yes No No No

Isthisapplicationbeingcompletedtoregisteryourfirstlocationtocollectdocumentarystamptax?..................................... Yes . No If no, and this application is for additional locations, please list name and address of each additional location. (Attachadditionalsheetsifneeded.) Locationname __________________________________________ Telephonenumber_____________________________________________ Physicaladdress_________________________________________ City/State/ZIP ________________________________________________

SECTION G -- COMMUNICATIONS SERvICES TAX -- NO FEE
48. 49. 50. 51. Yes No Do you sell communications services? If yes, check the items below that apply......................................................................... a. Telephoneservice(local,longdistance,ormobile)............................................................................................................... Yes No b.Pagingservice........................................................................................................................................................................ Yes No No c. Facsimile(fax)service(notinthecourseofadvertisingorprofessionalservices)............................................................... Yes d.Cableservice.......................................................................................................................................................................... Yes No No e. Direct-to-homesatelliteservice............................................................................................................................................. Yes f. Paytelephoneservice ............................................................................................................................................................ Yes . No g. Reseller(onlysalesforresale;nosalestoanyretailcustomers) .......................................................................................... Yes . No No h.Otherservices;pleasedescribe:_____________________________________________________________________ Yes Doyoupurchasecommunicationsservicestointegrateintoprepaidcallingarrangements?..................................................... Yes No Areyouapplyingforadirectpaypermitforcommunicationsservices?................................................................................... Yes No Checktheappropriatebox(es)forthemethod(s)youintend tousefordeterminingthelocaltaxingjurisdictionsinwhichserviceaddressesfor yourcustomersarelocated.Ifyouusemultipledatabases,checkallthatapply.Ifyouonlysellpaytelephoneordirect-to-homesatelliteservices, provideprepaidcallingarrangements,areareseller,orareapplyingforadirectpaypermit,skipquestions51and52. 1. AnelectronicdatabaseprovidedbytheDepartment. 2a.Adatabasedevelopedbythiscompanythatwillbecertified. Toapplyforcertificationofyourdatabase,completean Application for Certification of Communications Services Database (FormDR-700012). 2b.Adatabasesuppliedbyavendor.Providethevendor'sname: ________________________________________________ Twocollectionallowanceratesareavailable. ·Dealerswhosedatabasesmeetthecriteriainitems1,3,or4aboveare eligiblefora.75percent(.0075)collectionallowance. ·Dealerswhosedatabasesmeetthecriteriainitem5areeligiblefora .25percent(.0025)collectionallowance. ·Dealersmeetingthecriteriainitem2aareeligiblefora.25percent (.0025)collectionallowanceuntilthedatabaseiscertified.Upon certification,thedealerwillreceivethe.75percent(.0075)collection allowance. ·Dealersmeetingthecriteriain2bareeligibleforthe.75percent(.0075) collectionallowanceifthevendor'sdatabasehasbeencertified.Ifnot, the.25percentcollectionallowance(.0025)willapply. Dealerswithmultipledatabasesmayneedtofiletwoseparate returnsinordertomaximizetheircollectionallowances. ·IfalldatabasesarecertifiedoraZIP+4methodisused,thenthe dealerisentitledtothe.75percent(.0075)collectionallowance. ·IfsomedatabasesarecertifiedoraZIP+4methodisused,andsome arenot,thedealerhastwooptionsforreportingthetax.Oneisto fileasinglereturnforalltaxablesalesfromalldatabasesandreceive a.25percent(.0025)collectionallowance.Thesecondoptionisto filetworeturns:onereportingtaxablesalesfromcertifieddatabases (.75percentallowance)andaseparatereturnforthetaxablesales fromnon-certifieddatabases(.25percentallowance). ·Ifnodatabasesarecertified,thedealerwillreceivea.25percent (.0025)collectionallowanceonalltaxcollected. 3. ZIP+4andamethodologyforassignmentwhenZIPcodes overlapjurisdictions. 4. ZIP+4thatdoesnotoverlapjurisdictions. Example:ahotellocatedinonejurisdiction. 5. Noneoftheabove.







52.

If you wish to be eligible for both collection allowances, check the box below to indicate that you will file two separate returns. Iwillfiletwoseparatecommunicationsservicestaxreturnsinordertomaximizemycollectionallowance.

53. Providethenameofthemanagerialrepresentativewhocananswerquestionsregardingfiledtaxreturns. Name ___________________________________________________ Telephone ________________________________________________ _ E-MailAddress ___________________________________________ _ StreetAddress _____________________________________________

SECTION H -- APPLICANT DECLARATION AND SIGNATURE
This application will not be accepted if not signed by the applicant.

DR-1 R. 01/06 Page 6

Iftheapplicantisasoleproprietorship,theproprietororownermustsign;ifapartnership,apartnermustsign;ifacorporation,anofficerofthe corporationauthorizedtosignonbehalfofthecorporationmustsign;ifalimitedliabilitycompany,anauthorizedmemberormanagermustsign;if atrust,atrusteemustsign;ifapplicantisrepresentedbyanauthorizedagentforunemploymenttaxpurposes,theagentmaysign(attachexecuted powerofattorney).THE SIGNATURE OF ANY OTHER PERSON WILL NOT BE ACCEPTED. Pleasenotethatanyperson(includingemployees,corporatedirectors,corporateofficers,etc.)whoisrequiredtocollect,truthfullyaccountfor, andpayanytaxesandwillfullyfailstodososhallbeliableforpenaltiesundertheprovisionsofsection213.29,FloridaStatutes.Allinformation providedbytheapplicantisconfidentialasprovidedins.213.053,F.S.,andisnotsubjecttoFloridaPublicRecordsLaw(s.119.07,F.S.). Under penalties of perjury, I attest that I am authorized to sign on behalf of the business entity identified herein, and also declare that I have read the information provided on this application and that the facts stated in it are true to the best of my knowledge and belief. SIGN HERE ______________________________________________________________ Printname____________________________________________________________ Amountenclosed:$__________________________

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Title __________________________________________ Date __________________________________________

· $5 fee­Salestaxregistrationforbusiness/propertylocatedinFlorida. · $30 fee­Solidwasteregistrationfordrycleaners.

USE THIS CHECKLIST TO ENSURE FAST PROCESSING OF YOUR APPLICATION.
Completetheapplicationinitsentirety. MakesurethatyouhaveprovidedyourFEINorSSN. Signanddatetheapplication. Attachcheckormoneyorderforappropriateregistrationfee amount. DO NOT SEND CASH. Mailto: FLORIDA DEPARTMENT OF REvENUE 5050 W TENNESSEE ST TALLAHASSEE FL 32399-0100 You may also mail or deliver your application to any service center listed on the inside front cover.

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