Amusement Machine Certificate Form – Fill Out and Use This PDF

Application for Amusement Machine Certiicate

DR-18N N. 01/16

General Information and Instructions

Rule 12A-1.097

Florida Administrative Code

Effective 01/16

A Coin-Operated Amusement Machine is any machine operated by coin, slug, token, coupon, or similar device for the purpose of entertainment or amusement. Amusement machines include: coin-operated radios and televisions, telescopes, pinball machines, music machines, juke boxes, mechanical rides, video games, arcade games, billiard tables, shooting galleries, and all other similar amusement devices.

Purpose of this Application. This application is used to obtain an annual Amusement Machine Certiicate (DR-18C) for each location where you operate one or more coin-operated amusement machines. The annual fee is $30 per machine. To complete this application, you must have an active sales and use tax Certiicate of Registration (Form DR-11) for each county in which the machines are operated.

If you do not have a sales tax number for each county where your machines are located for operation, you can register to collect and report tax through our website at www.mylorida.com/dor. The site will guide you through an application interview that will help you determine your tax obligations. If you do not have Internet access, you can complete a paper Florida Business Tax Application (Form DR-1).

If you wish to operate more machines at any location than the number currently listed on your Amusement Machine Certiicate for that location, you must complete another application and pay $30 for each additional machine.

If you move your amusement machines from one location to another location within the same county, contact the Department to correct the machine location on your certiicates. If you move your amusement machines to another county, you must irst have a sales and use tax Certiicate of Registration in that county before contacting the Department to update the machine location on your certiicates.

Your amusement machine certiicate expires on June 30th each year. You must renew amusement machine certiicates before that date. A renewal notice containing information on your Amusement Machine Certiicates will be mailed to you 30 to 60 days before

the certiicate’s expiration date. If you do not receive a renewal notice, you may use this application to renew your annual amusement machine certiicates. Be sure to check the box “Annual Renewal Application.”

Who is Required to Purchase and Display Amusement Machine Certiicates? The amusement machine operator responsible for removing the receipts from the machine and paying sales tax and applicable surtax on the machine receipts is required to purchase and display the Amusement Machine Certiicates (DR-18C).

When the business owner, where the machines are located, is the owner of the amusement machines, the business owner is the amusement machine operator and the person required to purchase and display the Amusement Machine Certiicates.

The business owner where the amusement machines are operated is considered to be the operator and required to purchase the Amusement Machine Certiicates, even when the business is not the owner of the machines. However, the operator responsibilities may be otherwise speciied in a written agreement between the business owner and the amusement machine owner.

How is the Certiicate Fee Calculated? The annual certiicate fee is $30 for each machine times the maximum number of machines operated at that location. Certiicates are valid for a period of one year, July 1 to June 30. The annual fee is non-refundable and cannot be prorated based on the time of year the certiicate is purchased.

Where Do I File the Application and Required Fee? This application and the required $30 per machine fee may be delivered to the nearest Florida Department of Revenue service center or mailed to the address below. Make your check (U.S. funds only) or money order payable to the Florida Department of Revenue.

Florida Department of Revenue

Amusement Machine Certiicate - MS 1-5600

5050 W Tennessee St

Tallahassee FL 32399-0156

Application for Amusement Machine Certiicate

DR-18 R. 01/16

q Initial Application

q Add Locations or Machines q Annual Renewal Application

Amusement Machine Operator Information:

Rule 12A-1.097

Florida Administrative Code

Effective 01/16

Be Sure To:

•Indicate the type of application you are submitting:

›Initial Application › Adding locations or machines

›Annual Renewal Application

•Obtain a sales and use tax Certiicate of Registration number for each county in which you will operate amusement machines before you complete this application.

•If you have a consolidated sales tax account, be sure to enter your county sales tax certiicate number for the county in the Amusement Machine Location Information, not your consolidated sales tax account number.

Amusement Machine Location Information

Enter your county or location sales and use tax Certiicate of Registration number for this location. If this is your irst application for a certiicate for machines operated at this location, check the box for “New Location.” If you are adding machines to a previously issued certiicate, check the box for “Change Amusement Machine Certiicate” and enter the number of additional machines that will be operated at this location. If you did not receive a renewal application from the Department and you are using this application to renew your certiicate, check the box “Annual Renewal.” Be sure to enter the maximum number of machines to be operated at each location. Multiply the number of machines by $30 to compute the fee due for each location.