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Question	Answer
Form Name	Fl Dr 1 Form
Form Length	15 pages
Fillable?	Yes
Fillable fields	211
Avg. time to fill out	22 min 58 sec
Other names	florida tax application, florida dr, business tax application florida, florida business tax application dr 1

Additional Florida location for		Sales and use tax for this location will be reported using my current:
currently registered business		(select all that apply)
Date of first taxable activity: __/ __/ ____		consolidated return	county control reporting number
	mm dd yyyy
Additional Florida rental property for		Sales and use tax for this location will be reported using my current:
currently registered business		(select all that apply)
Date of first taxable activity: __/ __/ ____		consolidated return	county control reporting number
	mm dd yyyy
Moved registered Florida location to		Current sales and use tax certificate number for location
another Florida county -		____ -_____________________ -__
Effective date:	__/ __/ ____	(this number will be cancelled)
	mm dd yyyy	Sales and use tax for this location will be reported using my current
		(select all that apply)
		consolidated return	county control reporting number

Starting a new taxable activity at a
registered location -		Current sales and use tax certificate number for location
Effective date:	__/ __/____	__ __ - __ __ __ __ __ __ __ __ __ __ - __

	Acquired existing business -
	Effective date:	__/ __/ ____
		mm dd yyyy

3. Business Name, Location, and Mailing Address:			Others - Use name filed with the Florida Department of State or
Sole proprietors - Use last name, first name, middle initial			similar agency in another state


Street address:	Florida County:	Telephone #:	Check if # is outside U.S.

4. Is this business location only open during a portion of a calendar year?				Yes	No
If yes, provide the:
First calendar month this business location is open:			; and the
Last calendar month this business location is open:			.
5. Form of Business Ownership: (select only one form of ownership)
Sole Proprietor (individual owner)	Limited liability company (LLC)			Estate
Partnership (select one below):	(select one below):			Trust
Married couple		Single member		Business
General partnership		Multi-member		Other
Limited liability partnership (LLP)	If single member,select the box that			Governmental agency
Limited partnership (LP)	applies to how your LLC is treated for
Joint venture	federal income tax.
Corporation (select one below):		C Corporation
C Corporation		S Corporation
S Corporation		Disregarded (reported by single member)
Not-for-profit	If multi-member, select the box that applies
Foreign corporation	to how your LLC is treated for federal
	income tax.
		Partnership

or FEIN:	__ __ -__ __ __ __ __ __ __

Telephone #:	Check if # is outside U.S.

<![endif]>Applicants	<![endif]>Background
<![endif]>All Applicants -	<![endif]>Business Activities

Has your business ever been known			Name:
by another name?	Yes	No

Was that business issued a Florida certificate			Number:
of registration or tax account number?	Yes	No

11. Business Activities:			Primary code
Enter the six-digit North American Industry Classification
System (NAICS) code(s) that best describes your		__ __ __ __ __ __		__ __ __ __ __ __
business activities at this location. Enter your primary		__ __ __ __ __ __		__ __ __ __ __ __
code first. (Enter at least one.)		__ __ __ __ __ __		__ __ __ __ __ __
		__ __ __ __ __ __		__ __ __ __ __ __

Name:				FEIN:

Address:				Florida certificate or tax account number:

City / State / ZIP:				If acquired, portion acquired:
				All	Part	Unknown

Did your business share any common ownership, management, or			Did the previous legal entity or acquired business have employees
control with the acquired business at the time of acquisition?			at the time of the change or acquisition?
Yes	No		Yes	No

Were employees transferred to the new legal entity or new			Date transferred:
business?		__ /__ /____
Yes	No	__ /__ /____
			mm dd yyyy

	Purchases
		Purchase items to use in my business without paying Florida sales tax to the seller at the time of purchase (such
<![endif]>Tax		as from a seller located outside Florida)
		Applying for a direct pay permit to self-accrue and remit use tax directly to the Department
<![endif]>Use
		To apply for a permit, submit an Application for Self-Accrual Authority/Direct Pay Permit Sales and Use Tax

<![endif]>and		(Form DR-16A).
		Applying for authority to remit sales tax to the Department for independent sellers or distributors (see Rule
<![endif]>Sales
		12A-1.0911, Florida Administrative Code, for more information)


		This business does not conduct activities at this location subject to Florida sales and use tax

<![endif]>WasteSolidFees Surchargeand	15.	Do you sell (at retail) new tires for motorized vehicles at this location that are sold separately or as	Yes
		part of a vehicle?
	16.	Do you sell (at retail) new or remanufactured lead-acid batteries at this location that are sold separately
	16.
		or as a component part of another product such as new automobiles, golf carts, or boats?	Yes
	17.	Do you rent, lease, or sell car-sharing membership services at this location for the use of motor vehicles
		that transport fewer than nine passengers?	Yes

<![endif]>Cleaning	18.	Do you own or operate a dry-cleaning plant or dry drop-off facility in Florida?	Yes	No
<![endif]>Cleaning	<![endif]>Tax	Registration Package (GT-400401) for fuels and pollutants.
		If yes, and you import or produce perchloroethylene or other dry-cleaning solvents, you must also complete a
<![endif]>Dry-
Reemployment Tax

19.	Do you have or will you have, employees in Florida?				Yes	No
20.	Do you, or will you, lease workers from an employee leasing company to work in Florida?				Yes	No
	If yes, provide the following:
	Name of leasing company:

	FEIN:		Department of Business and Professional Regulation license number:

	Portion of workforce that is leased:		Date of leasing agreement for workers in Florida:
	All	Part	__ / __	/____
	All	Part

			mm dd	yyyy

21. Do you use the services of persons in Florida whom you consider to be self-employed, independent contractors other
than those engaged in a distinct business, occupation, or profession that serves the general public (e.g., plumber,
general contractor, or certified public accountant)?	Yes	No

22. Is your business registered for reemployment tax?	Yes	No
If yes, provide your RT account number: __ __ __ __ __ __ __
Are you currently reporting wages to the Florida Department of Revenue?	Yes	No
Are you reactivating your reemployment tax account?	Yes	No
23. On what date did you, or will you, first have an employee in Florida? __ / __	/____
mm dd	yyyy

Have you or will you pay gross wages of at least $1,500 within a calendar quarter?		Yes	No
If yes, provide the date you reached or will reach $1,500 gross wages.	__ / __	/____
	mm dd	yyyy
Have you or will you have one or more employees for a day (or portion of a day) during 20 or more
weeks in a calendar year?		Yes	No
If yes, provide the last day of the 20th week.	__ / __	/____
	mm dd	yyyy

Have you or will you employ four or more workers for a day (or portion of a day) during 20 or more		Yes	No
weeks in a calendar year?
If yes, provide the last day of the 20th week.	__ / __	/____
If yes, provide the last day of the 20th week.	mm dd	yyyy
	mm dd	yyyy


Agricultural (noncitrus, citrus, or crew chief) employer
Have you or will you pay gross wages of at least $10,000 within a calendar quarter?	Yes	No
If yes, provide the date you reached or will reach $10,000 gross wages.	__ / __	/____
	mm dd	yyyy
Have you or will you have five or more employees for a day (or portion of a day) during 20 or more
weeks in a calendar year?	Yes	No
If yes, provide the last day of the 20th week.	__ / __	/____
	mm dd	yyyy

City / State / ZIP:				Number of employees:

Principal products or services:	If services, indicate if:
	Administrative	Research	Other


Address:

City / State / ZIP:				Number of employees:

Principal products or services:	If services, indicate if:
	Administrative	Research	Other


Address:

City / State / ZIP:				Number of employees:

Principal products or services:	If services, indicate if:
	Administrative	Research	Other


Address:

City / State / ZIP:				Number of employees:

Principal products or services:	If services, indicate if:
	Administrative	Research	Other

Reporting Forms and Information	Tax Rate Information	Benefits Paid Information
Employer's Quarterly Reports, Certifications,	Tax Rate Notices	Notice of Benefits Paid
Reporting-related Correspondence:	Related Correspondence:	Related Correspondence:
Business Information (address in the	Business Information (address	Business Information (address in the
the first section of this application)	in the first section of this application)	first section of this application)
Payroll Agent Information (address	Payroll Agent Information	Payroll Agent Information (address
in Question 27)	(address in Question 27)	in Question 27)
Other (enter below)	Other (enter below)	Other (enter below)

Telephone service (e.g., local, long distance, wireless, or VOIP)		Video service (e.g., television programming or streaming)
Paging service		Direct-to-home satellite service
Facsimile (fax) service (not when providing advertising or		Pay telephone service
professional services)		Purchase services to integrate into prepaid calling arrangements
Reseller (only sales for resale; no sales to retail customers)
Other services; please describe:

or Visa #:__ __

__ __ __ __ __ __

__ __ -__ __ __ __ __ __ __

Telephone #:

Check if # is outside U.S.