Form Dr-26 - Application For Refund Form Page 3
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3DR-26
R. 07/06
I paid state and/or local option fuel tax and believe I am due a refund because:
Tax was paid on diesel fuel used by a non-commercial vessel (p. 10)
Tax was paid on kerosene used for home heating (p. 10)
Tax was paid on diesel fuel used in a vessel for commercial fishing purposes (p. 10)
Tax was paid on undyed diesel fuel mixed with dyed diesel fuel (p. 10)
Tax was paid on diesel fuel used in the production of electricity (p. 10)
Tax was paid on fuel purchases by foreign diplomats at retail stations (p. 10)
Other (explain):
I paid pollutant tax and believe I am due a refund because:
Tax was paid on petroleum products that were bunkered into marine vessels engaged in
interstate or foreign commerce (p. 10)
Tax was paid on pollutants exported from Florida (p. 10)
I consumed, blended or mixed a tax-paid solvent to produce a non-pollutant (p. 10)
I adjusted my original return to reflect a reduction in tax due (amended return) (p. 10)
Other (explain):
I paid aviation fuel tax and believe I am due a refund because:
Tax was paid on sales to the federal government (p. 11)
Other (explain):
I paid corporate income and emergency excise tax and believe I am due a refund because:
The Department of Revenue deposited my check in error (intended for IRS or another entity) (p. 11)
A duplicate payment was issued on my final return ( p. 11)
I paid insurance premium tax and believe I am due a refund because:
The Department of Revenue deposited my check in error (p. 1)
A duplicate payment was issued on my final return (p. 1)
I am an individual or business and believe I am due a refund because:
Other (p. 1)
Explain:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Part 8
REFUND SUBPROCESS
For further information regarding the DR-6,
Attach documentation
FLORIDA DEPARTMENT OF REvENUE
the documentation required to process the re-
and send this
PO BOx 6490
fund, or to check on an application after it has
application to:
TALLAHASSEE FL 32314-6490
been submitted, call us at 850-488-8937.
FAx: 850-410-2526
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CLEAR FIELDS
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