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DR-1C

R. 06/04

Application for Collective Registration

MAIL TO:

CENTRAL REGISTRATION

For Rental of Living or Sleeping Accommodations

FLORIDA DEPARTMENT OF REVENUE

5050 W TENNESSEE STREET

TALLAHASSEE FL 32399-0100

Agent/Representative/Management Company Sales Tax Registration Information

_________________________________________________

___ ___ - ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ - ___

Agent/Representative/Management Company Name

Florida Sales and Use Tax Registration Number for this County

_________________________________________________

________________________________________________

Mailing Address

Print/Type Name of Agent/Representative/Management Co.

_________________________________________________

_________________

_______________________

Signature of Agent

Date

Telephone Number

(THIS APPLICATION CANNOT BE PROCESSED WITHOUT AGENT’S SIGNATURE)

Number of Accommodations or Time-Share Units Included in this Application or Attached Schedule __________________________

Total Registration Fees $ _____________________

County of Properties on this Application ____________________________

(One County Per Application)

INDIVIDUAL PROPERTY LOCATION INFORMATION

Time-Share? Yes___ No___ Effective date: ___________________

_________________________________________________

________________________________________________

Name of Property Owner(s) or Time-Share Unit #/Designation

Owner’s FEIN (Not Required for Time-Share Units)

_________________________________________________________________________________________________________

Rental Property Address

City

County

State

ZIP

Is property located within the city limits? Yes___ No___

Property Owner's Phone Number: _________________________

_________________________________________________________________________________________________________

Owner’s Mailing Address (Not Required for Time-Share Units)

City

County

State

ZIP

For DOR Office Use Only

Filing Frequency

S.I.C.

Kind Code

Sales and Use Tax Registration Number

_____MO _____QU _____SA _____AN _____SE

___ ___ ___ ___

___ ___

___ ___ - ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ - ___

INDIVIDUAL PROPERTY LOCATION INFORMATION

Time-Share? Yes___ No___ Effective date: ___________________

_________________________________________________

________________________________________________

Name of Property Owner(s) or Time-Share Unit #/Designation

Owner’s FEIN (Not Required for Time-Share Units)

_________________________________________________________________________________________________________

Rental Property Address

City

County

State

ZIP

Is property located within the city limits? Yes___ No___

Property Owner's Phone Number: _________________________

_________________________________________________________________________________________________________

Owner’s Mailing Address (Not Required for Time-Share Units)

City

County

State

ZIP

For DOR Office Use Only

Filing Frequency

S.I.C.

Kind Code

Sales and Use Tax Registration Number

_____MO _____QU _____SA _____AN _____SE

___ ___ ___ ___

___ ___

___ ___ - ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ - ___

Form Dr-1c - Application For Collective Registration For Rental Of Living Or Sleeping Accommodations

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