Form Dr-248 - Alternative Fuel Use Permit Application, Renewal, And Decal Order Form - 2008

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DR-248
2008 Alternative Fuel Use Permit
R. 11/07
Application, Renewal, and Decal Order Form
Permit Number:
For Period Ending:
FEIN or Social Security Number:
Enter owner name, location address, and mailing address
Computation of 2008 Decal Fee(s)
Name of
Class A
Class B
Class C
Class A + B + C
county in
which the
Total
Annual
Rate
x Number
= Class Total
Rate
x Number
= Class Total
Rate
x Number
= Class Total
vehicle is
predominately
of Vehicles
of Vehicles
of Vehicles
vehicles
Fees
used
191.40
261.00
365.40
191.40
261.00
365.40
261.00
365.40
191.40
191.40
261.00
365.40
191.40
261.00
365.40
191.40
261.00
365.40
191.40
261.00
365.40
261.00
365.40
191.40
Total
+
=
+
Decals
$
$
$
Annual
+
=
+
Fees
x
Proration Factor
(see Lines 9 and 10 of instructions)
$
Total Fees Due
Print or type applicant’s name _____________________________________________________
Title ____________________________________Contact phone number ___________________________
I certify that this application has been examined by me and to the best of my knowledge and belief is true and complete.
Signature of applicant ____________________________________________________________________
Note: Social security numbers are used by the Florida Department of Revenue as unique identifiers for the administration of
Florida’s taxes. Social security numbers obtained for tax administration purposes are confidential under sections 213.053 and
119.071, Florida Statutes, and not subject to disclosure as public records.

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