Free DR-42A - Florida

Ownership Declaration and Sales and Use Tax Report on Aircraft
Purchaser's Name: ______________________________________________________________ Address: ______________________________________________________________________ City, State, ZIP: ________________________________________________________________ Telephone Number: _____________________________________________________________ Florida Sales Tax Number (Registered Dealers Only): __________________________________

DR-42A R. 03/02

STATEMENT OF PURCHASER
The aircraft purchased is a __________, __________, __________, bears serial number___________________ and FAA registration
(year) (make) (model

number_______________________. Total amount paid for this aircraft was $_________________ and a lien in the amount of $____________________ is held by: _____________________________________________________________________________ . The aircraft described herein was purchased from ___________________________________________________________________
(name of seller)

_____________________________________________________________________________________________ on ___/___/___.
(address) (city) (state) (zip) (date)

Delivery of this aircraft was taken at _______________________________________________ and arrived in Florida on ___/___/___.
(city) (state) (zip) (date)

Total purchase price ................................................... Less: trade-in ............................................................ Net purchase price ..................................................... Florida sales tax due at 6% ........................................ Florida discretionary surtax ........................................ Penalty ....................................................................... Interest ....................................................................... Sub-total ..................................................................... Less credit for tax paid in another state* ............... TOTAL DUE

$ _____________________________ ( ______________________________ ) ______________________________ ______________________________ ______________________________ ______________________________ ______________________________ $ _____________________________ ( ______________________________ ) $ _____________________________

*You must include a copy of the Bill of Sale which shows the correct purchase price (not the F.A.A. Bill of Sale) even if no tax is due. Please make your check payable to the Florida Department of Revenue. The plane is presently located at ________________________________________________________________________________
(FBO) (city) (state) (zip)

and its permanent FBO/tie-down location is _______________________________________________________________________
(city) (state) (zip)

The aircraft was bought for the following purpose(s) _________________________________________________________________ . This purchaser also owns ______ other aircraft and they have the following FAA registration numbers: _________________________ STATE OF FLORIDA, COUNTY OF ______________________________________________________________________________ Sworn to (or affirmed) and subscribed before me this _____________ day of __________, A.D., _________.
(Day of Month) (Month) (Year)

______________________________________________
(Signature of Purchaser/Affiant)

_______________________________________________
(Signature of Notary)

Personally Known _______________________ Or Produced Identification _______________________ Type of Identification Produced _______________________

_____________________________________________
Print, Type or Stamp Name of Notary

THIS DOCUMENT MUST BE RETURNED TO THE DEPARTMENT OF REVENUE WITHIN 15 DAYS FROM THE RECEIPT OF THIS NOTICE OR THE DATE OF PURCHASE.

PLEASE MAIL TO: DEPARTMENT OF REVENUE, COMPLIANCE ENFORCEMENT, PO BOX 6417, TALLAHASSEE, FL 32314-6417.