Free DR-15CS - Florida

Sales and Use Tax Return

DR-15CS R. 01/09
Rule 12A-1.097 Florida Administrative Code Effective 01/09

Please complete this return. Attach your check or money order and mail to:

Florida Department of Revenue 5050 W. Tennessee Street Tallahassee, FL 32399-0120
If the Department mails you a personalized form, instructions will be enclosed for completing your 2009 return. If you get a form from the Internet or one of our offices and need instructions, you may visit us online at www.myflorida.com/dor/forms or call 800-352-3671 (TDD at 800-367-8331 or 850-922-1115). Make certain you read the instructions for each line of the return before completing your 2009 Sales and Use Tax return.
Certificate Number:

SALES AND USE TAx RETURN HD/PM Date: 1. Gross Sales . . . .
Surtax Rate: Collection Period

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DR-15 R. 01/09

Florida
A. Sales/Services B. Taxable Purchases C. Commercial Rentals D. Transient Rentals E. Food & Beverage Vending
Transient Rental Rate:

2. Exempt Sales . . . .
Check here if donating collection allowance to education, and leave Line 11 blank.

3. Taxable Amount . . . . .
5. Total Amount of Tax Collected 6. Less Lawful Deductions 7. Total Tax Due 8. Less Est Tax Pd / DOR Cr Memo 9. Plus Est Tax Due Current Month 10. Amount Due 11. Less Collection Allowance 12. Plus Penalty 13. Plus Interest

Include use tax on Internet / out-of-state untaxed purchases

Name Address City/St/ZIP

Due: Late After: Check here if payment was made electronically.

Do Not Write in the Space Below

14. Amount Due with Return

4. Tax Collected . . . . . . . . . . . . . . .

9100 0 20099999 0001003031 5 4999999999 0000 5
SALES AND USE TAx RETURN HD/PM Date:

Certificate Number:

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/

DR-15 R. 01/09

Florida
A. Sales/Services B. Taxable Purchases C. Commercial Rentals D. Transient Rentals E. Food & Beverage Vending
Transient Rental Rate:

1. Gross Sales . . . .
Surtax Rate:

2. Exempt Sales . . . .
Collection Period Check here if donating collection allowance to education, and leave Line 11 blank.

3. Taxable Amount . . . . .
5. Total Amount of Tax Collected 6. Less Lawful Deductions 7. Total Tax Due 8. Less Est Tax Pd / DOR Cr Memo 9. Plus Est Tax Due Current Month 10. Amount Due 11. Less Collection Allowance 12. Plus Penalty 13. Plus Interest

Include use tax on Internet / out-of-state untaxed purchases

Name Address City/St/ZIP

Due: Late After: Check here if payment was made electronically.

Do Not Write in the Space Below

14. Amount Due with Return

4. Tax Collected . . . . . . . . . . . . . . .

9100 0 20099999 0001003031 5 4999999999 0000 5

Proper Collection of Tax: Florida's general sales tax rate is 6 percent; however, there is an established "bracket system" for calculating the tax due when any part of each total taxable sale is less than a whole dollar amount. Other rates may also apply. See instructions. Discretionary Sales Surtax: Most counties levy a discretionary sales surtax on most transactions subject to sales and use tax. These taxes are distributed to local governments throughout the state. The amount of money distributed is based on how you complete your tax return, especially the lines on the back of the return. Dealers should impose discretionary sales surtax on taxable sales when delivery or use occurs in a county that imposes surtax. Please see Form DR-15DSS (if enclosed) or visit us online at www.myflorida.com/dor/forms to obtain a copy. This form provides you with each county's discretionary sales surtax rate(s). Fraud Penalties: There are specific penalties imposed for fraud, fraudulent claim of exemption, failure to collect and pay over, or an attempt to evade or defeat the sales tax. Please see the instructions for detailed information regarding the penalties, fines, and punishments for certain sales tax offenses.

Under penalties of perjury, I declare that I have read this return and the facts stated in it are true (sections 92.525(2), 212.12, and 837.06, Florida Statutes).

Signature of Taxpayer

Date

Signature of Preparer

Date

Discretionary Sales Surtax ( Lines 15(a) through 15(d) )
15(a). Exempt Amount of Items Over $5,000 (included in Column 3) ............................................................................................ 15(a). _________________________________ 15(b). Other Taxable Amounts NOT Subject to Surtax (included in Column 3) .............................................................................. 15(b). _________________________________ 15(c). Amounts Subject to Surtax at a Rate Different Than Your County Surtax Rate (included in Column 3) .............................. 15(c). _________________________________ 15(d). Total Amount of Discretionary Sales Surtax Collected (included in Column 4)............................................................... 15(d). _________________________________ 16. 17. 18. 19. 20. 21. Total Enterprise Zone Jobs Credits (included in Line 6) ........................................................................................................ 16. _________________________________ Taxable Sales/Untaxed Purchases of Electric Power or Energy -- 7% Rate (included in Line A) ......................................... 17. _________________________________ Taxable Sales/Untaxed Purchases of Dyed Diesel Fuel -- 6% Rate (included in Line A)....................................................... 18. _________________________________ Taxable Sales from Amusement Machines (included in Line A) ............................................................................................ 19. _________________________________ Rural and/or Urban High Crime Area Job Tax Credits .............................................................................................................. 20. _________________________________ Other Authorized Credits .......................................................................................................................................................... 21. _________________________________

Under penalties of perjury, I declare that I have read this return and the facts stated in it are true (sections 92.525(2), 212.12, and 837.06, Florida Statutes).

Signature of Taxpayer

Date

Signature of Preparer

Date

Discretionary Sales Surtax ( Lines 15(a) through 15(d) )
15(a). Exempt Amount of Items Over $5,000 (included in Column 3) ............................................................................................ 15(a). _________________________________ 15(b). Other Taxable Amounts NOT Subject to Surtax (included in Column 3) .............................................................................. 15(b). _________________________________ 15(c). Amounts Subject to Surtax at a Rate Different Than Your County Surtax Rate (included in Column 3) .............................. 15(c). _________________________________ 15(d). Total Amount of Discretionary Sales Surtax Collected (included in Column 4)............................................................... 15(d). _________________________________ 16. 17. 18. 19. 20. 21. Total Enterprise Zone Jobs Credits (included in Line 6) ........................................................................................................ 16. _________________________________ Taxable Sales/Untaxed Purchases of Electric Power or Energy -- 7% Rate (included in Line A) ......................................... 17. _________________________________ Taxable Sales/Untaxed Purchases of Dyed Diesel Fuel -- 6% Rate (included in Line A)....................................................... 18. _________________________________ Taxable Sales from Amusement Machines (included in Line A) ............................................................................................ 19. _________________________________ Rural and/or Urban High Crime Area Job Tax Credits .............................................................................................................. 20. _________________________________ Other Authorized Credits .......................................................................................................................................................... 21. _________________________________