Form Dr-26 - Application For Refund Form
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3Florida Department of Revenue
DR-26
R. 07/06
Application for Refund
Use this form to apply for a refund for any of the taxes listed below in Part 6. Sales and use tax dealers must use form DR-6S, Application for Refund- Sales and Use Tax. For a refund
of annual (recurring) intangible personal property tax, use Form DR-6I, Application for Refund- Intangible Personal Property Tax. Taxpayers seeking a refund of property tax must use
Form DR-46, Application for Refund of Ad Valorem Taxes.
Mail application to:
Complete Parts 1 through 7 and attach appropriate
Refund Subprocess
Handwritten Example
Typed Example
documentation. Type or print clearly. Your refund
0123456789
Florida Department of Revenue
0 1 2 3 4 5 6 7 8 9
application will be rejected if red boxes are not
Use black ink.
PO Box 6490
completed in full.
Tallahassee FL 3314-6490
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
Sign and date this form.
Signature of applicant/representative:
Date:
Print name:
Title:
Important - A Florida Department of Revenue Power of Attorney (Form DR-835) must be properly executed and included if the
refund request is submitted by the applicant’s representative.
–
–
Representative’s phone number:
Part 3
$
Enter amount of refund.
,
,
.
Identification number of applicant:
Part 4
Provide the
Social security number:
For joint filers, spouse’s social security number:
identification number
under which the tax
–
–
–
–
was paid. If you do not
have a federal employer
Federal employer identification number:
Fuel tax license number:
identification number,
provide your social
–
security number.
Business partner number:
Part 5
Enter the period shown
Period
to
on the tax return(s)
M
M
D
D
Y
Y
M
M
D
D
Y
Y
used to report the tax
and/or when it was paid.
Paid
to
M
M
D
D
Y
Y
M
M
D
D
Y
Y
FOR DOR USE ONLY
DOC TYPE 76
Nonrecurring Intangible (08)
Part 6
Aviation Fuel (3)
Check the box next to
Documentary Stamp (19)
Corporate Income (0)
the type of tax you paid.
Communications Services (63)
Insurance Premium (16)
REFUND
A separate application
Motor Fuel (96)
Other (please specify)
Approval Amount $ _________________________________
must be completed for
Pollutant (34)
__________________________
each tax type.
Date ____________________________________________
Reasons for this refund (additional sheets may be added):
Part 7A
Clarify and speed
Review
up your refund claim
Refund Amount $ __________________________________
by providing a brief
explanation.
Date ____________________________________________
Approved By ______________________________________
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