Form DR-700025 Fillable Objection to Address/Jurisdiction Database for Local Communications Services Tax and Local Insurance Premium Tax Service Address Assignment R.10/13
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

a local taxing jurisdiction or Form DR 350907 if you are a special fire control district Address Lookup using https://pointmatch state fl us Address/Jurisdiction Database you must provide supporting evidence that the address is located within the jurisdiction Check all that apply: Communications Services Provider Individual (insured or purchaser of communications services) Communications Services Tax Address Vendor County Property Appraiser location search result using https://dor myflorida com/dor property/appraisers html FDOR Employee Insurance Company or Vendor https://pointmatch state fl us or contact us at 850 717 6630 for more information Local Government Unit PO Box 6530 Property tax bill Other Proposed jurisdiction assignment should be SUNTAX Contract Object page to show Distribution Stamp area County/JBP A/c field [COUNTY] (if applicable) Tallahassee FL 32314 6530 Voter registration card Master Street Address Guide Account Name: Owner Phone: address corrections may be submitted online Segregate your change requests based on the specific combination of affected address/jurisdiction corrections at https://pointmatch state fl us All requests can be submitted using the Department of Revenue s Internet site at: https://pointmatch state fl us Business Partner #: Certificate #: City/State/ZIP: E mail address: Communications Services Tax and Local Insurance Company: Street Address: County: ZIP: DR 700025 E mail: local govt unit@dor state fl us Fax: 850 921 4711 FDOR Employees Only: Provide a copy of the following screenshots: Florida Administrative Code FOR DOR USE ONLY For FDOR Employees only For SUNTAX related requests provide all of the following: Government Unit at 850 717 6630 or send an e mail to local govt unit@dor state fl us If none of these reasons apply use the space below to describe your objection: If you complete this form online do not mail a copy in the Department of Revenue s Address/Jurisdiction Database Department of Revenue employees should submit SUNTAX related indicated For example a copy of a property tax bill indicating the jurisdiction in which an address is located Instructions jurisdiction databases and other substantially affected parties may submit an objection to the jurisdiction assigned to an address jurisdictions and submit each combination separately For example submit all addresses moving from City A to City B in one Mail: Florida Department of Revenue Name: Title: NOTE: Requests submitted without evidence to support the address/jurisdiction objection will not be considered NOTE: To submit updates or corrections to the Department s Address/Jurisdiction Database use Form DR 700022 if you are Number and Street City: Objection to Address/Jurisdiction Database for Local Part A: Contact Information I am a (check one): Part B: Service Address Information To submit an objection for multiple addresses use the Department's Internet site at: Part C: Basis for Objection Complete the appropriate reason based on your objection (check all that apply) Part D: Competent Evidence To object to the jurisdiction to which an address is assigned in the Department of Revenue s Part E: Signature/Date Phone Number: Fax Number: Premium Tax Service Address Assignment Purchasers or providers of communications services insurers providing insurance coverage vendors providing address/ R 10/13 Reason 1 The address is listed in the wrong jurisdiction within the database Current jurisdictional assignment is Reason 2 The address is not listed in the database Proposed jurisdiction assignment should be Reason 3: The address information is incorrect (EX misspelled wrong ZIP code) Proposed correction to address: Reason 4: Required for all requests Rule 12A 19 100 See the Instructions below on how to submit the required documentation Signature: Date: submission separately from all addresses moving from City A to City C Submit your completed objection and all supporting evidence online at https://pointmatch state fl us or by e mail fax or mail to Tax Type: Owner Name (if not sole proprietor): The fastest and easiest way to submit your objections is online at https://pointmatch state fl us A single request for multiple the Florida Department of Revenue s Local Government Unit at: The service address I am objecting to has an effective date (if known) of: Tracking number Date Upon receipt of your submission the Department will contact the affected local jurisdictions For more information call the Local You must submit evidence showing that the affected addresses are located within the jurisdiction that you indicated