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Intangible Tax Self-Audit Worksheet – _____

DR-350111

R.06/07 Page 1 of 8

Name of taxpayer

Name of spouse

Address

City, State, ZIP

Taxpayer SSN	Spouse SSN

DR/SATS NO

	FOR DEPARTMENT USE ONLY
DOC: 21	TAX: 03

SCHEDULE A

DOLLARS

CENTS

1.	Bonds (from Schedule B, Line 9)	1.
2.	Stocks, mutual funds, money market funds and
	limited partnership interest (from Schedule C, Line 10)	2.
3.	Loans, notes and accounts receivable
	(from Schedule D, Line 11)	3.
4.	Beneicial interest in any trust (from Schedule E, Line 12)	4.

5.	Total taxable assets (total of Lines 1 through 4)	5.		,
6.	Tax due (from Tax Calculation Worksheet, Page 2, Line 6E)		6.
7.	Interest
	(from Interest Calculation Worksheet, Page 4, Line 13)		7.
8.	Penalty (not applicable)		8.
9.	Total due (Line 6 + Line 7)		9.

FOR YEARS 1999 AND AFTER, IF YOUR TAX DUE IS LESS THAN $60.00,

YOU ARE NOT REQUIRED TO PAY THE TAX DUE.

You may reproduce this self-audit form as necessary for disclosing your liability for years other than the target year. Should you have additional questions, please call our service center at 850-488-0810 and ask to speak with a tax auditor.

______________________________________	_____________________________________	______________________________________
Taxpayer signature	Spouse signature	Telephone number
______________________________________	_____________________________________	______________________________________
Date	Individual or irm preparing the worksheet	Telephone number

THIS WORKSHEET MUST BE RETURNED

TO CLEAR YOUR ACCOUNT.

YOUR RESPONSE IS REQUIRED WITHIN 30 DAYS.

Make checks

payable to: Florida Department of Revenue

Mail to: TALLAhASSEE CENTRAL SERvICE CENTER P.O. BOX 6417

TALLAhASSEE, FL 32314-6417

Neither foreign currency nor funds drawn on other than U.S. banks will be accepted. Florida law requires a service fee for returned checks or drafts of ﬁfteen ($15.00) dollars or ﬁve (5%) percent of the face amount, whichever is greater, not to exceed $150.00 (s. 215.34(2), F.S.)

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Intangible Tax Self-Audit Worksheet –

DR-350111

R.06/07 Page 2 of 8

Name of taxpayer:

Social security number:

Name of spouse:

Social security number:

TAX CALCULATION WORKSHEET													[Complete only one (1) column below]

Filing status					Step 1						INDIVIDUAL						JOINT

	If your taxable assets from								BOX A					BOX B		BOX C			BOX D
	If your taxable assets from
		Schedule A, Line 5 are:
		Schedule A, Line 5 are:						$100,000 or less				Greater than $100,000				$200,000 or less		Greater than $200,000
								$100,000 or less				Greater than $100,000				$200,000 or less		Greater than $200,000

6A.	Taxable assets				Step 2			$________________					$________________			$________________		$________________
	(Schedule A, Line 5)

6B.	Times tax rate								X______					X______		X______			X______
					Step 3
6C.	Gross tax				Step 3			$________________					$________________			$________________		$________________
	(Multiply Line 6A x Line 6B)

6D.	Less exemption								– $______					– $______		– $______			– $______
					Step 4
6E.	Net tax				Step 4			$________________					$________________			$________________		$________________
	(subtract Line 6D from Line 6C.)
	If less than zero, enter (-0-)

						CARRY TOTAL TAX DUE TO SCHEDULE A, LINE 6, PAGE 1

							TAX RATES AND EXEMPTION SCHEDULE

					INDIvIDUAL											JOINT
			Assets $ 100,000 or Less			Assets Greater than $ 100,000								Assets $ 200,000 or Less			Assets Greater than $ 200,000
TAX YEAR			RATE	EXEMPTION			RATE			EXEMPTION				RATE	EXEMPTION		RATE		EXEMPTION
1984-1990			.001	$	20.00		.0010			$	20.00			.001	$	40.00	.0010		$	40.00
1991-1992			.001	$	20.00		.0015			$	70.00			.001	$	40.00	.0015		$	140.00
1993-1999			.001	$	20.00		.0020			$	120.00			.001	$	40.00	.0020		$	240.00
2000			.001	$	20.00		.0015			$	70.00			.001	$	40.00	.0015		$	140.00
2001-2003			.001	$	20.00		.0010			$	20.00			.001	$	40.00	.0010		$	40.00
				INDIvIDUAL - assets any amount											JOINT - Assets any amount
2004-2005							.0010			$	250.00						.0010		$	500.00
2006							.0005			$	125.00						.0005		$	250.00

ENTER APPROPRIATE RATE AND EXEMPTION IN ShADED AREAS IN ThE TAX CALCULATION WORKShEET ABOvE

	BONDS
SCHEDULE B	Name of issuer, series

List alphabetically, one bond per line

Face Value	Interest
Per Bond	Rate
(A)	(B)

Maturity

Date

(C)

Number Per $100.00

Owned Value

(D)(E)

Total Taxable

Amount January 1, _____

9.TOTAL BONDS

Attach additional schedule if necessary. Photocopies of this schedule are acceptable.

CARRY THIS AMOUNT TO SCHEDULE A, LINE 1, PAGE 1

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Intangible Tax Self-Audit Worksheet –

DR-350111

R.06/07 Page 3 0f 8

Name of taxpayer:	Social security number:

Name of spouse:	Social security number:

SCHEDULE C	STOCKS, MUTUAL FUNDS, MONEY MARKET FUNDS						Stock Code
SCHEDULE C		AND LIMITED PARTNERSHIP INTERESTS					Do not write
		AND LIMITED PARTNERSHIP INTERESTS					in this space

			Class	Number	Just Value	Total
Name of Company Issuing Stocks			Common	of	Per	Just Value	Veriﬁed
(List alphabetically - do not abbreviate)			or	Shares	Share	January 1, _____	By
			Preferred	(A)	(B)	(A x B)





















10. TOTAL VALUE OF STOCKS
Attach additional schedule if necessary. Photocopies of this schedule are acceptable.
CARRY THIS AMOUNT TO SCHEDULE A, LINE 2, PAGE 1					10.

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Intangible Tax Self-Audit Worksheet –

DR-350111

R.06/07 Page 4 of 8

Name of taxpayer:										Social security number:

Name of spouse:										Social security number:


SCHEDULE D						LOANS, NOTES AND ACCOUNTS RECEIVABLE								Total Taxable Amount
SCHEDULE D						LOANS, NOTES AND ACCOUNTS RECEIVABLE								January 1, _____

A.	Accounts receivable

B.	Notes receivable

C.	Loans and advances receivable

D.	Other Receivables

11.	TOTAL VALUE OF LOANS, NOTES AND ACCOUNTS RECEIVABLE
	CARRY THIS AMOUNT TO SCHEDULE A, LINE 3, PAGE 1												11.


							TRUST PROPERTY ONLY							FEI Number of Trust
SCHEDULE E							TRUST PROPERTY ONLY
SCHEDULE E				BENEFICIAL INTEREST IN ANY TRUST (INDIVIDUAL RECEIVING INCOME)


Trust(s) iled by Florida trustee(s), ❏฀Yes ❏฀No								If YES, go no further.
								If NO, see Questions 1 and 2 below:

1.	Can you designate the future beneiciaries of the TRUST?								❏฀Yes ❏฀No
2.	Are you able to withdraw other than income from the TRUST?								❏฀Yes ❏฀No
2.	Are you able to withdraw other than income from the TRUST?								❏฀Yes ❏฀No					Total Taxable Amount
IF YOUR ANSWERS TO EITHER OR BOTH OF THESE QUESTIONS IS “YES”, READ INSTRUCTIONS.														Total Taxable Amount
														January 1, _____
														January 1, _____

	A.	Stocks

	B.	Bonds

	C.	Others

12.	TOTAL
	CARRY THIS AMOUNT TO SCHEDULE A, LINE 4, PAGE 1												12.

		INTEREST RATE SCHEDULE						YEAR		RATE	YEAR	RATE	YEAR		RATE

YEAR			RATE		YEAR		RATE	1992		180%	1997	120%	2002**		46%
1984			276%		1988		228%	1993		168%	1998	108%	2003**		37%
1985			264%		1989		216%	1994		156%	1999	96%	2004**		29%
1986			252%		1990		204%	1995		144%	2000**	69.5%	2005**		21%
1987			240%		1991		192%	1996		132%	2001**	57.5%	2006**		11.5%

** For returns DUE after 1999, the Department will use a loating rate of interest subject to change every 6 months.

INTEREST CALCULATION	(A)	(B)	(C)						Interest Due
WORKSHEET	Enter amount from	Interest Rate	Days						Interest Due
WORKSHEET	Line 6, Schedule A	(See Interest Rate Schedule)
	Line 6, Schedule A	(See Interest Rate Schedule)
Yearly Interest Rate		____ %						1. +
								1. +
					+
(July 1, _____ - June 30, 2007)
(July 1, _____ - June 30, 2007)									(A x B)
									(A x B)
Fixed Daily Interest Rate for returns 1984 - 1999							2a. +
Fixed Daily Interest Rate for returns 1984 - 1999		.000328767				+
(July 1, 2007 to postmark date of payment)		.000328767
(July 1, 2007 to postmark date of payment)									(A x B x C)

**Floating Daily Interest Rate								2b. +
**Floating Daily Interest Rate		.000328767				+
(July 1, 2007 to postmark date of payment)		.000328767
(July 1, 2007 to postmark date of payment)									(A x B x C)
									(A x B x C)
13. TOTAL
13. TOTAL							=
CARRY THIS AMOUNT TO SCHEDULE A, LINE 7, PAGE 1				13.			=
CARRY THIS AMOUNT TO SCHEDULE A, LINE 7, PAGE 1				13.

**Calculate the total number of days from July 1 to the postmark date and enter the total days in Column C.

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DR-350111

R.06/07 Page 5 of 8

Instructions for Completing the

Intangible Tax Self-Audit Worksheet

General Information

The Florida Intangible Personal Property Tax is an annual tax based on the market value of the intangible property owned by a Florida resident or other individual(s) obligated to pay the intangible tax.

Intangible personal property is deined as all personal property which is not itself valuable, but is valuable because of what it represents. The most common examples are: shares of stock issued by corporations; bonds issued by corporations or state, county or municipal governments outside the state of Florida; accounts receivable or other loans which are not secured by real property; shares or units of ownership in mutual and money market funds.

Who Must File a Return**

Every person who is a legal resident or who is domiciled in this state on January 1 of the tax year is required to ile an intangible tax return if they own, manage, or control intangible personal property. Individuals and married couples can either ile Form DR-601 or DR-601AI when iling a return. Corporations, partnerships, afiliated groups, and iduciaries are to ile on Form DR-601C or DR-601AC.

If tax due on Line 6 is less than $60.00, you are not required to ﬁle a return. however, we recommend that you submit a return to avoid future contact regarding this tax year. Trustees and personal representatives are required to ile a return listing all intangible property owned by the trust or estate if the beneiciaries are including the trust or estate assets on their personal return. This return is to advise the Department that the beneiciaries have iled returns, including the intangible property on their personal returns and under what number the returns have been iled.

Exemptions

See Page 2, Tax Rates and Exemption Schedule

Custodians of minors and incompetents may ile a return and claim the exemption on behalf of the minor or incompetent using the minor’s or incompetent’s social security number. Agents and iduciaries may not claim the exemption in their own right or on behalf of their principals or beneiciaries.

The following types of intangible property are exempt from taxation:

1.Money - this includes cash on hand and in the bank, certiicates of deposit, annuities and similar instruments.

2.Units of a registered investment company which is organized under an indenture of trust (unit investment trust or Massachusetts type business trust) shall have the portion of its net asset value exempt from tax which is equal to the portion of the portfolio containing United States government debt obligations. If the fund is incorporated, the entire fund is taxable.

3.All intangible property held in an employee retirement plan qualiied under section 401, United States Internal Revenue Code, as amended.

4.All intangible property held in an Individual Retirement Account (IRA) qualiied under section 408, United States Internal Revenue Code, as amended. This includes Roth and Educational IRA’s.

5.All intangible property held in a deferred compensation plan which is offered to governmental employees and qualiied under section 457, United States Internal Revenue Code, as amended.

6.Interest in a general partnership or franchise.

7.Interest in a limited partnership not registered with the Securities and Exchange Commission.

8.REMICS.

9.Bonds, notes, and other obligations issued by the state of Florida, its counties, municipalities, or other taxing districts, and the United States government and its agencies, territories and possessions. These investments when held in a fund may be taxable.

10.Notes and other obligations, except bonds, to the extent secured by a lien on real property located inside or outside the state.

Question	Answer
Form Name	Form Dr 350111
Form Length	8 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	2 min
Other names	Intangible Tax Self Audit Worksheet tax audit worksheets form

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