Form Dr-601i - Florida Intangible Personal Property Tax Return Form For Individual And Joint Filers - 2002 Page 2

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DR-601I
R. 01/02
Important Information Requested
Month
Day
Year
Example:
0 6 1 0 2 0 0 1
M M D D Y Y Y Y
1.
What is the date that your Florida residency was established?
These two items may assist you in establishing a residency date:
A) The first year you qualified for homestead exemption. B) The first day you were qualified to register to vote in Florida.
2.
Do you reside outside Florida during a portion of the year?
Yes
No
If yes, enter your non-Florida address: ___________________________________________________________________________
When do you normally reside there? from________ until________ Phone number at above address: ( _____ )-_______-__________ .
3.
If your filing status has changed or is incorrect, please complete the information below:
A) Marriage
B) Divorce
C) Death (see Instructions, Filing Status , Page 6)
M M D D Y Y Y Y
M M D D Y Y Y Y
M M D D Y Y Y Y
Date of Marriage
Date of Divorce
Date of Death
Spouse’s SSN
Your SSN
SSN of Deceased
4.
If your name/mailing address/SSN has changed or is incorrect, complete the following:
Taxpayer #1
Taxpayer #2
Name _________________________________________________
Name ______________________________________________________
Correct SSN ____________________________________________
Correct SSN ________________________________________________
New Address ___________________________________________
New Address ________________________________________________
City/State/ZIP ___________________________________________
City/State/ZIP _______________________________________________
Telephone Number ( __________ ) __________________________
Telephone Number ( ___________ ) _____________________________
Signature ______________________________________________
Signature ___________________________________________________
Tax Calculation Worksheet
(Complete only ONE column below)
Instructions: Determine which column applies based on filing
status. Complete only the applicable column.
Individual
Joint
1. Enter Total Taxable Intangible Assets from Schedule A, Line 5
$
$
2. Subtract Personal Exemption
– $20,000
– $40,000
3. Taxable Assets
$
$
4. Multiply by Tax Rate
x .001
x .001
5. Total Tax Due, carry Amount to Schedule A, Line 6
$
$
601-I
Make check payable to: Florida Department of Revenue
(Include SSN on check)
Mail to:
FLORIDA DEPARTMENT OF REVENUE
Do not mark in this area
5050 W TENNESSEE ST
TALLAHASSEE FL 32399-0140
Note:
Neither foreign currency nor funds drawn on other than U.S.
banks will be accepted. State law requires a service fee for
returned checks or drafts of fifteen ($15) dollars or five (5%)
percent of the face amount, whichever is greater, not to
exceed $150 [s.215.34(2), F.S.].

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