Form DR-228 Fillable Documentary Stamp Tax Return For Nonregistered Taxpayers' Unrecorded Documents R.08/11
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

(from Step 5 of the worksheet) (from Step 6 of the worksheet) (see instructions) (see instructions) (sum of Lines 4 through 7) 5050 W Tennessee St Certain renewal notes Leases with an unconditional promise to pay Notes and other written obligations to pay Retail installment sale contracts Signature of Taxpayer Date Tallahassee FL 32399 0150 Title loans Title Phone Number (include area code) US Dollars Cents $ 35 per $100 or fraction thereof Florida law limits the maximum tax due on $ 35 per $100 or portion thereof Florida law limits the maximum tax due on $ 45 = $2 411 10 $ 45 surtax per $100 or portion thereof of the consideration paid or to be $535 750 Tax calculation: 5 358 (taxable $100 units) x $ 70 = $3 750 60 (on real property other than a single family dwelling held in the conduit entity) ***DETACH COUPON*** 1 000 (taxable $100 units) x $ 35 = $350 00 1 and July 1 of each year To obtain interest rates go to the Department s 1 Subtotal $ 2 522 (taxable $100 units) x $ 35 = $882 70 2 Subtotal $ 20th of the month following the execution month Returns and payments 3a Surtax Subtotal $ 3b Tax Subtotal $ 4 Miami Dade County Surtax Due 4a Surtax Subtotal $ 4b Tax Subtotal $ 5 Documentary Stamp Tax Due 5050 W TENNESSEE ST 6 Penalty 7 Interest 8 Total Amount Due with Return 800 352 3671 800 367 8331 or 850 922 1115 9100 0 20141225 0019025036 5 4000001189 2797 4 a document was executed and/or issued a single family dwelling) situated in Miami Dade County is delivered for an application interview that will help you determine your tax obligations If and no mortgage or other lien is filed or recorded in Florida Tax calculation: any Florida county including Miami Dade is delivered for consideration of are executed or delivered in Florida Examples include: are postmarked by the next business day as public records Collection of your SSN is authorized under state and federal at $ 60 per $100 or portion thereof of the consideration paid or to be paid Bonds: Tax is calculated at $ 35 per $100 or portion thereof Tax is due on calculation: 4 042 (taxable $100 units) x $ 70 = $2 829 40 calculation: 5 358 (taxable $100 units) x $ 45 = $2 411 10 calculation: 5 358 (taxable $100 units) x $ 60 = $3 214 80 City/State/ZIP collection use or release of SSNs including authorized exceptions Complete the information requested and carry subtotals to the front of Conduit Entity (see s 201 02(1)(b) F S and Rule 12B 4 060 F A C ) consideration of $535 750 Surtax calculation: 5 358 (taxable $100 units) x counties except Miami Dade; Miami Dade is $ 60 per $100 and surtax of $ 45 County county other than Miami Dade is delivered for consideration of $404 105 Tax Do Not Write in the Space Below Documentary Stamp Tax Return For Documentary Stamp Tax Return For DR 228 DR 228 due on documents that contain a promise to pay a sum certain in money and Effective 04/12 Every person who executes or issues instruments described below and has Example 1: A deed transferring interest in real property situated in Example 2: A deed transferring interest in real property situated in any Florida Example: A corporate bond in the amount of $100 000 is issued in Florida Example: A deed transferring interest in unimproved real property (not Example: A note of $252 150 is executed signed or delivered in Florida Example: An instrument transferring interest in real property situated in Example: An instrument transferring ownership interest in a conduit entity except Miami Dade; Miami Dade is $ 70 per $100 and surtax of $ 45 per $100 file a DR 225 tax return You can register to collect and/or report tax through Filing Tips Florida Administrative Code Florida Business Tax Application formerly the Application to Collect and/or Florida Department of Revenue FLORIDA DEPARTMENT OF REVENUE in Miami Dade County is delivered for consideration of $535 750 Surtax Instruments Transferring Interest in Real Property in Florida: For real Interest: Interest is due from the date tax is due until paid Florida law Internet site is calculated at $ 70 per $100 or portion thereof of the consideration paid or law Visit our Internet site at www myflorida com/dor and select Privacy less than five taxable transactions per month may report documentary stamp Make check payable to and send with return to: Miami Dade County is delivered for consideration of $535 750 Tax more taxable transactions per month must register with the Department and Nonregistered Taxpayers Unrecorded Documents Nonregistered Taxpayers Unrecorded Documents notes and other written obligations to $2 450 notes and other written obligations to $2 450 However there is no limit on Notes and Other Written Obligations to Pay Money: Tax is calculated at Notice for more information regarding the state and federal law governing the o All documents listed must be executed and/or issued in the same month A separate form must be completed for each month in which o Complete all information requested on the coupon o DO NOT attach original or copies of deeds or other documents to this return o DO NOT submit a photocopy of a DR 228 tax return o Keep a copy of this return and a copy of your check for your records Canceled check serves as your receipt of payment o Mail coupon to: Florida Department of Revenue o SIGN AND DATE THE RETURN o Taxpayers with five or more taxable transactions per month must register with the Department o Use Worksheet on reverse side to complete lines 4 8 on the tax return coupon below of consideration or fraction thereof of the month following the execution month SEE INSTRUCTIONS ON REVERSE SIDE or call Taxpayer Services Monday through Friday 8 a m to 7 p m ET at or fraction thereof our Internet site at www myflorida com/dor The site will guide you through owning unimproved real property (not a single family dwelling) situated paid where the property transferred is other than a single family residence Penalty: If you are late filing your return or paying tax add a late penalty of 10 per $100 (on real property other than a single family dwelling) of consideration percent of the tax due for each month or portion of a month not to exceed 50 percent of the tax due Minimum penalty is $10 Persons with hearing or speech impairments may call our TDD at postmarked after the 20th are late However if the 20th falls on a Saturday property situated in all counties in Florida except Miami Dade County tax Property Tax Rate: $ 70 per $100 of consideration or fraction thereof in all provides for a floating rate of interest that is established using a formula in R 08/11 R 08/11 Report Tax in Florida Obtain Form DR 1 from your nearest Department of Resources: Visit the Department s Internet site at www myflorida com/dor return ) return and the facts stated in it are true Revenue as unique identifiers for the administration of Florida s taxes Revenue service center or call Taxpayer Services at 800 352 3671 Rule 12B 4 003 section 213 235 Florida Statutes Interest rates are updated on January sections 213 053 and 119 071 Florida Statutes and not subject to disclosure Social security numbers (SSNs) are used by the Florida Department of SSN (if no FEIN) SSNs obtained for tax administration purposes are confidential under Step 1 Notes and Other Written Obligations to Pay Money Tax Rate: Step 2 Bonds Tax Rate: $ 35 per $100 or fraction thereof Step 5 Surtax due (sum of steps 3a and 4a Carry to line 4 on front of Step 6 Documentary stamp tax due (sum of steps 1 2 3b and 4b Carry Steps 3a and 3b Instruments Transferring Interest in Florida Real Steps 4a and 4b Instruments Transferring Ownership Interest in a Street Address Sunday or state or federal holiday returns will not be considered late if they TALLAHASSEE FL 32399 0150 Tax Rate: $ 70 per $100 of consideration or fraction thereof in all counties tax using this tax return Taxpayer Copy Taxpayer Name taxpayers reporting documentary stamp tax on unrecorded documents the original issuance of bonds in Florida based on the face value of the bond the tax due for recorded instruments such as a mortgage or other lien Tax is This return is for nonregistered taxpayers only and is due no later than the 20th this tax return to be paid For real property situated in Miami Dade County tax is calculated to line 5 on front of return ) Under penalties of perjury I declare that I have examined this tax What tax return do registered taxpayers use? Any person with five (5) or When are returns due? Returns and payments are due no later than the where the property transferred is a single family residence; and at $ 60 plus Where to Send Payments and Returns: Who must file a DR 228 tax return? This form is for nonregistered Worksheet for Completing Form DR 228 you do not have Internet access you can complete and submit Form DR 1