Free DR-248 - Florida

2009 Alternative Fuel Use Permit Application, Renewal, and Decal Order Form
Permit Number: For Period Ending:
Enter owner name, location address, and mailing address

DR-248 R. 03/09
Rule 12B-5.150 Florida Administrative Code Effective 04/09

FEIN or Social Security Number:

Computation of 2009 Decal Fee(s)
Name of county in which the vehicle is predominately used

Class A
Rate x Number = Class Total of Vehicles Rate

Class B
x Number = Class Total of Vehicles Rate

Class C

Class A + B + C
Annual Fees

x Number = Class Total Total of Vehicles vehicles

194.70 194.70 194.70 194.70 194.70 194.70 194.70 194.70 Total Decals Annual Fees

265.50 265.50 265.50 265.50 265.50 265.50 265.50 265.50

371.70 371.70 371.70 371.70 371.70 371.70 371.70 371.70

+ $ + $

+ + $

= = x $

Proration Factor (see Lines 9 and 10 of instructions)
Print or type applicant's name _____________________________________________________

Total Fees Due

Title ____________________________________Contact phone number ___________________________
I certify that this application has been examined by me and to the best of my knowledge and belief is true and complete.

Signature of applicant ____________________________________________________________________ Note: Social security numbers are used by the Florida Department of Revenue as unique identifiers for the administration of Florida's taxes. Social security numbers obtained for tax administration purposes are confidential under sections 213.053 and 119.071, Florida Statutes, and not subject to disclosure as public records.

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DR-248 R. 03/09 Page 2

GENERAL INFORMATION
"Alternative fuel" is liquefied petroleum gas or compressed natural gas product (or combination) used in an internal combustion engine or motor to propel any form of vehicle or machine. Alternative fuel also includes all forms of fuel commonly or commercially known or sold as butane gas, propane gas or any other form of liquefied petroleum gas, or compressed natural gas. (Reference: Section 206.86(4) Florida Statutes.) All owners or operators of vehicles powered by alternative fuel must: · Obtain a valid Alternative Fuel Use Permit from the Department of Revenue. · Pay an annual decal fee on each motor vehicle according to the current rate schedule. (This fee is paid instead of the excise tax imposed by Chapter 206, F.S.) The Department issues annual decals beginning January 1st of each year. Decals are valid January 1st through December 31st for the year issued. The decal must be attached to the upper corner of the front windshield on the driver's side of the motor vehicle for which it is issued. For motorcycles or other vehicles without a windshield, the decal must be placed where it is plainly visible at all times. Persons fueling vehicles from their own facilities must pay an annual decal fee for each cent of tax imposed by counties with a localoption fuel tax. This annual decal fee is: · $11.00 for each cent of tax imposed on Class A vehicles · $15.00 for each cent of tax on Class B vehicles · $21.00 for each cent of tax on Class C vehicles (See sections 336.021 and 336.025, F.S. This fee is in addition to the state alternative fuel fee imposed by sections 206.877(1)(a) and 336.026(1)(b), F.S.) Persons who do not operate their own fueling facilities must indicate and pay the appropriate local fee for the particular county where the vehicles are predominately used. It is unlawful for any person to operate a motor vehicle required to have a decal upon the highways of this state without a decal unless that motor vehicle is titled outside the state. No person may put liquefied petroleum gas or compressed natural gas into the fuel supply tank of a motor vehicle required to have an alternative fuel decal unless the vehicle has a decal attached to it as required by this section. When transacting sales of fuel placed into a vehicle displaying a decal, record the sale on an invoice, and include on the invoice the decal number, the motor vehicle license number, and the number of gallons placed into the motor vehicle. A valid identifying decal issued to a motor vehicle will be transferable to the new owner of that vehicle for the remainder of the issuance period if the owner notifies the Department of such transfer within ten days of the transfer.

How to Complete the Alternative Fuel Use Permit--Application and Decal Order Form
1. Determine the name of the county in which the vehicle is predominantly used. (Persons who do not operate their own fueling facilities should determine the county where each vehicle(s) is predominately used and fueled.) Determine the class code of each vehicle as defined below: · A hearse or ambulance · Motor vehicles for hire which transport nine passengers or more · Recreational vehicles or motor homes whose net weight is 4,500 pounds or more · Motor vehicles for hire operated wholly within a city or within 25 miles of the city Class C · Heavy trucks or truck tractors whose gross vehicle weight is 5,001 pounds or more 3. 4. Enter the county name in which the vehicle or machine is primarily used and number of vehicles for each class. For each class, multiply the number of vehicles by the corresponding rate and enter each Class Total. (State fees and local option fees have been combined.) For each county code, add the number of vehicles under each class and enter the sum in the Total Vehicles column under Class A+B+C. For each class, determine the total decals by adding the figures in the Number of Vehicles column. Enter the sum in the Total Decals row. The total of the number of vehicles under Class A+B+C must agree with the total of the Total Decals row. For each county code, add the class total dollar amounts and enter the sum in the Annual Fees column under Class A+B+C. Determine the annual fees by adding the dollar amounts in each Class Total column. Enter the sum in the Annual Fees row for each class. The sum of the Class A+B+C Annual Fees must agree with the sum of the dollar amounts in the Annual Fees row for Classes A, B, and C.
Continued on next page

2.

Class A · Motorcycles · Mopeds · Motorized bicycles · Automobiles for private use · Trucks whose net weight does not exceed 5,000 pounds · Antique trucks with a net weight of not more than 3,000 pounds · Manufactured more than 20 years prior to the current date, or an engine manufactured to the specifications of the original engine · Motor vehicles for hire which transport less than nine passengers · Recreational vehicles or motor homes whose net weight is less than 4,500 pounds Class B · Semi-trailers equipped with machinery and designed for the exclusive purpose of well drilling, excavating, construction, spraying or similar activity · School buses used exclusively to transport students to and from school or church activities or functions within their county · Motor vehicles operated solely as a wrecker, owned and operated by a garage in connection with its regular business

5.

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DR-248 R. 03/09 Page 3

How to Complete the Alternative Fuel Use Permit--Application and Decal Order Form (continued)
Proration Factor 9. Select the appropriate proration factor. A motor vehicle owner who applies for the decal: · After March 31 will pay three-fourths (.75) of the fee. · After June 30 will pay one-half (.50) of the fee. · After September 30 will pay one-fourth (.25) of the fee. If you require additional decals during the year, your fee and eligibility for prorated decals will be based on the postmark date of your application. Enter the proration factor in the appropriate box. (Prorated fees are defined by section 206.877(2), F.S.) 10. To determine the total fees due, multiply the annual fees by the proration factor. Enter the result in the Total Fees Due box. 11. Complete and sign the application. 12. Send your check, made payable to the Florida Department of Revenue, along with this application to: Account Management Fuel Unit Florida Department of Revenue P.O. Box 6480 Tallahassee, FL 32314-6480 850-488-4772