Dr-261 7/06 - Application For Refund - Intangible Personal Property Tax Form - Florida Department Of Revenue

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DR-26I
R. 07/06
Application for Refund - Intangible Personal Property Tax
Use this form to apply for a refund of annual intangible personal property Tax.
Complete Parts 1 through 6 and attach appropriate documentation. Type or print clearly.
Mail application to:
Refund Subprocess
Florida Department of Revenue
PO Box 6490
Tallahassee FL 32314-6490
Fax: 850-410-2526
**Your refund application will be rejected if fields in red are not completed in full.
Part 1 Fill in
Name of applicant:
Mailing street address:
Mailing city, state, ZIP:
Location street address:
Location city, state, ZIP:
Business telephone number
Home telephone number
(include area code):
(include area code):
Fax number (include area
E-mail address
code optional):
(optional):
(
)
Part 2
If signed by a taxpayer’s
representative, see
Signature of applicant/representative:
Date:
instructions on Page 3.
Print name:
Title:
Part 3
$
Enter amount of refund
,
,
.
requested.
Part 4
Identification number of applicant:
Provide the
Social security number:
For joint filers, spouse’s social security number:
identification number
under which the tax was
paid.
Federal employer identification number:
FOR DOR USE ONLY
DOC TYPE 76
Part 5
/
/
Enter the year shown
Tax Year(s):
on the tax return(s)
REFUND
M
M
D
D
Y
Y
and/or the date(s) tax
Approval Amount $ _________________________________
was paid.
/
/
Date(s) Paid:
M
M
D
D
Y
Y
Date ____________________________________________
Reasons for this refund (additional sheets may be added):
Part 6
Review
Clarify and speed
Refund Amount $ __________________________________
up your refund claim
by providing a brief
explanation.
Date ____________________________________________
Approved By ______________________________________

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