Free DR-1CON - Florida

Application for Consolidated Sales and Use Tax Filing Number

DR-1CON R. 03/05

This application is for use by sales and use tax certificate holders who have multiple business locations each of which is currently registered with the Department of Revenue, and who wish to make a single monthly tax payment for all locations. All business locations to be consolidated must be owned by the same entity. They need not be located in the same county. Consolidated filers are required to file their tax returns and remit their tax payments electronically. Filing your tax return and remitting your tax payment electronically is advantageous to both you and the Department. Transmitting electronically: · · · · Eliminates errors in your return -- audit checks are in the software. Eliminates paperwork -- you no longer have to complete and submit a paper return. Ensures timely and proper credit for filing -- you receive an acknowledgment that your tax return was accepted. Allows you to "warehouse" your payment. Warehousing is a method by which taxpayers may send their electronic payment and return early but the payment will not be processed until the date specified by the taxpayer (usually the due date of the payment). The payment is held in the banking system until the specified date, at which time the taxpayer's bank account is debited. May also allow you to import data from spreadsheet applications -- eliminates data entry time and errors.

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For more information regarding EFT, EDI or Web Filing, call the Department at 850-488-6800 or 800-352-3671. If you have questions regarding this application, call Central Registration at 850-488-9750. For information regarding consolidated filing of returns, call the Consolidated Return Reconciliation Unit at 850-488-9020. Please provide all information requested below. 1. Owner Name:___________________________________________________________________________________________________
Enter the individual, principal partner, or the corporate name

2.

Business Name: ________________________________________________________________________________________________
Enter business, trade or fictitious (d/b/a) name

3. 4.

Contact Person: _____________________________________________________ Phone(

) ____________________ Ext ________

Mailing Address: ________________________________________________________________________________________________
Enter address where you want to receive correspondence

City: _____________________________________________ State: ____________ County: ____________ ZIP: ___________________ 5. Federal Employer Identification Number (FEIN): If an FEIN is not required, or not yet received, enter Social Security Number (SSN): 6. 7. If a corporation, partnership or limited liability company, enter fiscal year ending month and year: Type of Organization:

MM Y Y

Corporation Partnership Sole Proprietorship Trust Professional Association Limited Liability Company Other (explain) _________________________________________________

8.

Describe your major business activities (the primary reason why you are registered for sales and use tax). _________________

______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________

9.

Are you currently or should you be obligated for one or more of the following tax liabilities: Vending Amusement Retail Food/Beverage Wholesale Food/Beverage Retail other Tire Battery Dry Cleaning Retail Fuel Sales Marina Off Road Diesel Month of first consolidated filing (effective date is the first of the month; allow four weeks for processing): _________________ List the complete Sales and Use Tax Number (as shown on your certificate, Form DR-11) for each business location you wish to report under this consolidated number. Attach additional sheets, if necessary.

10. 11.

12.

Applicant Signature --This Application Cannot Be Processed If Not Signed by the Applicant.

I certify, under penalty of perjury, that the statements herein have been examined by me and are, to the best of my knowledge and belief, true, complete and correct. ________________________________________________________________
Signature of Business Owner, Principal Partner, or Corporate Officer

______________________________________
Date Application Signed

________________________________________________________________
Print or Type the Name Signed Above

______________________________________
Title of Signatory

Please note that any person (including employees, corporate directors, corporate officers, etc.) who is required to collect, truthfully account for, and pay any sales taxes and willfully fails to do so shall be personally liable for such taxes under the provisions of s. 213.29, Florida Statutes. Mail this completed application to: Florida Department of Revenue Central Registration PO Box 6480 Tallahassee, FL 32314-6480

Or, FAX to: 850-922-5938 There is no fee required for registering to file a consolidated return.

FOR DOR OFFICE USE ONLY BP____________ CA____________ Kind Code CO____________ SIC Consolidated Number Number of Locations





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