Free DR-700001 - Florida

Municipal Public Service Tax Database Report

DR-700001 R. 10/01

This form is intended to be used to comply with s. 166.233(2), F.S. All Florida municipalities and charter counties must provide this information to the Florida Department of Revenue, sending changes as they occur. Any change in a tax levy or rate must be reported at least 120 days before the change occurs. Please fill in all information on each municipal public service not administered by a municipality, or its separate utility authority, board, or commission. (No information is required for any service administered by a municipality or its separate authority, board, or commission.) Note: Tax levies for communications services are no longer reported to the Department of Revenue using this form. To report communications service tax levies and levy changes local officials must use form DR-7000021.

Municipality _____________________________________________________________ County _____________________________________________________________

Service
Gas: Natural Liquefied Petroleum Manufactured Electric Water Fuel Oil/Kerosene

Tax Rate**

Effective Date Repeal Date

**Enter tax rate. If no tax is imposed, enter "0%." If voluntarily reporting self-administered tax, enter tax rate and "S/A."

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Preparer Name

Return completed form to: FLORIDA DEPARTMENT OF REVENUE GENERAL TAX ADMINISTRATION COMPLIANCE SUPPORT 5050 W TENNESSEE ST TALLAHASSEE FL 32399-0100

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Government Contact Person

Telephone

Street/PO Box

City

ZIP Code

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Preparer Phone

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Preparer Signature

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Date

PHONE 850-487-2544 FAX 850-487-3348

For DOR Use Only Date Entered _________________________ By _________________________________