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Form Dr-95a - Schedule Of Florida Sales Or Use Tax Credits Claimed On Tangible Personal Property Repossessed

DR-95A

Florida Department of Revenue

R. 04/95

Schedule of Florida Sales or Use Tax Credits Claimed on Tangible Personal Property Repossessed

Attachment to Return for

(Month -Year)

Sales Tax Certificate of Registration Number

(If Applicable)

Sales Tax

Purchase

Purchase Price

Length of

Monthly

Sales

Number of

Actual

Property

Date Tax

Paid on Orig.

Price Less

Less Trade-In

Contract

Payment X

or Use

X Payments =

Tax

Date of

Customer's Name

Description

Paid

Pur. Price

Trade-In

Less Cash Down

Months

Prorated

Tax Rate

Unpaid

Credits

Repossession

-1-

-2-

-3-

-4-

-5-

-6-

-7-

-8-

-9-

-10-

-11-

-12-

Certification

This is to certify the undersigned was the seller of the tangible personal property sold to the above listed customers; that the Florida sales or use tax was remitted to the Florida

Department of Revenue as stated on this schedule; and the tangible personal property was repossessed within the last twelve months preceding the month during which this claim

is being made. Certification is also made that the tangible personal property on this schedule was financed by the seller and subsequently repossessed; or that the tangible personal

property was financed through a financial institution with recourse and the seller, under the terms of the recourse agreement, repurchased the finance papers and repossessed the

tangible personal property. Therefore, claim is hereby made for sales or use tax attributable to that portion of the sales price which remained unpaid at the time of repossession. It is

understood any false or fraudulent statements in conjunction with this claim may result in prosecution as provided by the law.

Name of Dealer

Authorized Signature

Title

Date

(Instructions and applicable Department of Revenue Rule reference on reverse side.)