Form DR-700030 Fillable Application for Self-Accrual Authority / Direct Pay Permit R.06/06
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

$100 000 for the Florida communications services tax only (s 202 12 F S ) $100 000 for the Florida communications services tax statewide and $25 000 for the local communications services tax per (Form DR 700031) 800 352 3671 A communications services tax certificate/business partner number is required for processing this request if you a Communications Services Tax Direct Pay Permit Account Management application for self accrual authority / Direct Pay Permit Business name Communications services tax certificate/business partner number * category under which your business qualifies City/State/ZIP Telephone number (include area code) Communications services Tax Communications services Tax Communications Services Tax Direct Pay Permit communications services tax direct pay permit as indicated; and furthermore that if granted the communications services tax direct pay permit will communications services tax to be paid shall communications services tax to be paid shall not communications services The amount of state communications services will only be known Complete Parts 1 and 2 Complete street address City state ZiP Contact person's mailing address (if different than above) City/State/ZIP determination of the use of the services rather than direct pay permit Direct Pay Permit for interstate Communications Direct Pay Permit for Tax Due upon Determination DR 700030 EFF DATE electronically exceed $25 000 per service address note: Entities exemption either from the state communications ExP DATE Florida Department of Revenue FLORIDA DEPARTMENT OF REVENUE PERMIT NO For general information about communications services for self accrual authority / Direct Pay Permit granted have not registered for this tax and do not have a certificate/business partner number you must complete and I HEREBY ATTEST THAT: I am authorized to sign on behalf of the entity described above; that this entity has circumstances that qualify it for the Information and forms are available on our Internet site at information and instructions for Completing application DR 700030 instructions for Completing the application legal entities Qualifying entities will be issued a direct pay permit according to their particular qualifying circumstances local communications services taxes on interstate location 1 location 2 location 3 location 4 location 5 mail or deliver your completed application to: MAIL TO: This aRea foR DoR use only Name of contact person Contact person's telephone number (include area code) not exceed $100 000 The amount of the local Note the specific uses of the direct pay permit if note: incomplete or unsigned applications will be of use [s 202 27(6)(b) F S ] only be used in the manner authorized pursuant to the appropriate sections of Chapter 202 F S Under penalties of perjury I declare that I have read Page 2 PaRT 1 Business infoRmaTion PaRT 2 DiReCT Pay PeRmiT CaTegoRy foR WhiCh you aRe aPPlying (CheCk only one): PaRT 3 aPPliCanT affiRmaTion anD DeClaRaTion paying tax at the time of the purchase permit in lieu of paying tax to their communications services provider PO Box 6480 Print name purchases made in connection with the direct pay permit issued Purposes and use of Permits qualifying for this permit category will be required R 06/06 R 06/06 Read and sign Part 3 returned thus delaying the issuance of the Review the purposes stated above and identify the Sections 202 12 and 202 19 Florida Statutes provide that self accrual authority shall be granted to qualifying single service address (s 202 19 F S ) List each service address that qualifies for the partial exemption below Attach additional services [ss 202 12(3) and 202 19(8) F S ] Services Monday through Friday 8 a m to 7 p m ET at services tax only or from both the state and the services to accrue and remit taxes upon services used by the entity are for communications services where the majority of the communications services where the taxable status of sales of sheets if necessary Signature Street address Federal Employer Identification Number (FEIN) submit the Application to Collect and/or Report Tax in Florida (Form DR 1) This application and the DR 1 may be submitted together Tallahassee FL 32314 6480 Tax due upon determination of use [s 202 27(6)(b) F S ] The taxable status of sales of communications services tax or assistance with this application call Taxpayer terminate within the state This business has paid or will pay an amount in excess of (check only one): that originate outside of Florida and terminate the communications services used by this business are for communications that originate outside of Florida and the information on this application and that the facts stated in it are true [ss 92 525(2) and 837 06 Florida Statutes] The permit allows purchasers of communications This authority is granted for only two distinct purposes as described below Direct pay permit holders may extend their This direct pay permit allows the purchaser a partial Title to report and remit the tax to the Department upon use Qualified businesses will receive a use of interstate communications services [sections 202 12(3) and 202 19(8) Florida Statutes] The majority of What can the direct pay permit be used for? Who qualifies? Purchasers of communications will only be known upon use; the purchaser will pay the amount of tax to be determined upon use due on all of its within the state Qualified businesses will receive www myflorida com/dor