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Form Dbpr Abt-6024 - Application For Cigarette/tobacco Wholesaler, Tobacco Exporter, Or Cigarette Distributing Agent Page 5

SECTION 6 – SALES TAX

TO BE COMPLETED BY THE DEPARTMENT OF REVENUE

Trade Name (D/B/A)

The named applicant for a license/permit has complied with the Florida Statutes concerning registration for

Sales and Use Tax.

1. This is to verify that the current owner as named in this application has filed all returns and that all

outstanding billings and returns appear to have been paid through the period ending

___________________ or the liability has been acknowledged and agreed to be paid by the

applicant. This verification does not constitute a certificate as contained in Section 212.10 (1),

Florida Statutes. (Not applicable if no transfer involved.)

2. Furthermore, the named applicant for an Alcoholic Beverage License has complied with Florida

Statutes concerning registration for Sales and Use Tax, and has paid any applicable taxes due.

Signed____________________________________________________Date_____________________

Title______________________________________________________

Department of Revenue Stamp:

Form Dbpr Abt-6024 - Application For Cigarette/tobacco Wholesaler, Tobacco Exporter, Or Cigarette Distributing Agent Page 5