Free DR-15EZCS - Florida

Sales and Use Tax Return

DR-15EZCS 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.

FLORIDA SALES AnD USE TAx RETURn Collection Period
Certificate Number: Surtax Rate:

DR-15EZ R. 01/09 DOR USE OnLy
postmark or hand delivery date

Location/Mailing Address Changes: New Location Address:

name Address City/St/ZIP

Telephone Number: ( ) New Mailing Address: ________________________________________

Amount Due From Line 9 On Reverse Side

,

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

9100 0 20099999 0001003043 6 4999999999 0000 5

FLORIDA SALES AnD USE TAx RETURn Collection Period
Certificate Number: Surtax Rate:

DR-15EZ R. 01/09 DOR USE OnLy
postmark or hand delivery date

Location/Mailing Address Changes: New Location Address:

name Address City/St/ZIP

Telephone Number: ( ) New Mailing Address: ________________________________________

Amount Due From Line 9 On Reverse Side

,

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

9100 0 20099999 0001003043 6 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.

1. Gross Sales

(Do not include tax)

2. Exempt Sales

(Include these in Gross Sales, Line 1) (Include Internet/Out-of-State Purchases) (Include Discretionary Sales Surtax from Line B)

3. Taxable Sales/Purchases 4. Total Tax Collected

, ,

DOLLARS

5. Less Lawful Deductions 6. Less DOR Credit Memo 7. Total Tax Due 8. Less (-) Collection Allowance; or if Late, Plus (+) Penalty and Interest 9. Amount Due With Return (Enter this amount on front)

, , , , , , , , , , , , , , , , , ,

CEnTS

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 Information A. Taxable Sales and Purchases nOT Subject to DISCRETIOnARy SALES SURTAx B. Total Discretionary Sales Surtax Collected
Check here

, ,

if donating collection allowance to education, and leave Line 8 blank.

Please do not fold or staple.

1. Gross Sales

(Do not include tax)

2. Exempt Sales

(Include these in Gross Sales, Line 1) (Include Internet/Out-of-State Purchases) (Include Discretionary Sales Surtax from Line B)

3. Taxable Sales/Purchases 4. Total Tax Collected

, ,

DOLLARS

CEnTS

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

5. Less Lawful Deductions 6. Less DOR Credit Memo 7. Total Tax Due 8. Less (-) Collection Allowance; or if Late, Plus (+) Penalty and Interest 9. Amount Due With Return (Enter this amount on front)

Discretionary Sales Surtax Information A. Taxable Sales and Purchases nOT Subject to DISCRETIOnARy SALES SURTAx B. Total Discretionary Sales Surtax Collected
Check here

, ,

if donating collection allowance to education, and leave Line 8 blank.

Please do not fold or staple.