Form Dr-601i - Florida Intangible Personal Property Tax Return For Individual And Joint Filers - 2005 Page 2

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DR-601I
R. 01/05
Important Information Requested
Month
Day
Year
1.
If this is your first year filing, what is the date that your
Example:
0 6 1 0 2 0 0 4
M M D D Y Y Y Y
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 7.)
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
– $250,000
– $500,000
3. Taxable Assets
$
$
4. Multiply by Tax Rate
x .001
x .001
5. Total Tax Due, Carry Amount to Schedule A, Line 6
If the Total Tax Due is less than $60, you do not need
to file or pay.
$
$
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
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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