Form Dr-700016 - Florida Communications Services Tax Return - 2002

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Florida Communications
DR-700016
Services Tax Return
R. 01/02
Name
Address
City/State/ZIP
BUSINESS PARTNER NUMBER
FEIN
Check here if you are discontinuing your business
and this is your final return (see page 15)
REPORTING PERIOD
Handwritten Example
Typed Example
TO:
FROM:
0123456789
0 0 0 0 0 1 1 1 1 1 2 2 2 2 2 3 3 3 3 3 4 4 4 4 4 5 5 5 5 5 6 6 6 6 6 7 7 7 7 7 8 8 8 8 8 9 9 9 9 9
Use black ink.
M
M
D
D
Y
Y
Y
Y
M
M
D
D
Y
Y
Y
Y
US Dollars
Cents
,
,
1.
Tax due on sales subject to the state portion of the
communications services tax (from Summary of Sched. I, Col. F, Line 3) .... 1.
2.
Tax due on sales subject to the gross receipts portion of the
,
,
communications services tax (from Summary of Sched. I, Col. G, Line 6) ... 2.
3.
Tax due on sales subject to the local portion of the communications
,
,
services tax (from Summary of Sched. I, Col. H, Line 7) .............................. 3.
,
,
4.
Tax due for direct-to-home satellite services (from Schedule II, Column C) 4.
,
,
5.
Total communications services tax (add Lines 1 through 4) ......................... 5.
,
,
6.
Collection allowance. Rate:________________ ......................................... 6.
(If rate above is blank, check one) ❑ None applies ❑ .0025 ❑ .0075
,
,
7.
Net communications services tax due (subtract Line 6 from Line 5) ............ 7.
,
,
8.
Penalty .......................................................................................................... 8.
,
,
9.
Interest .......................................................................................................... 9.
,
10. Adjustments (from Schedule III, Column G and/or
,
Check here
Schedule IV, Column U) ...........................................................
10.
if negative
,
,
11. Multistate credits (from Schedule V) ........................................................... 11.
,
,
12. Amount due with return ............................................................................... 12.
Under penalties of perjury, I hereby certify that this return has been examined by me and to the best of my knowledge and belief is a true and complete return. [ ss. 92.525(2),
AUTHORIZATION
203.01(1), and 837.06, Florida Statutes].
Type or print name
Authorized signature
Date
Preparer (type or print name)
Preparer’s signature
Date
Contact name (type or print name)
Contact phone number
Payment Coupon
DO NOT DETACH
DR-700016
To ensure proper credit to your account, attach your check to
R. 01/02
this payment coupon. Mail with tax return and all schedules.
DOR USE ONLY
D
Check here if your address or
business information changed
Business Partner Number
Reporting Period
postmark or hand delivery date
R
and enter changes below.
-
Business Address
Location/mailing address changes:
7
New location address:
______________________________________
0
_________________________________________________________
0
_________________________________________________________
Telephone number:
(______)__________________________________
0
New mailing address:
________________________________________
1
_________________________________________________________
6
_________________________________________________________
Electronic Funds Transfer:
,
,
Amount due
Check here if payment was transmitted electronically.
from Line 12
Payment is due on the 1
st
and LATE
if postmarked or hand delivered after
9999 9 99999999 9999999999 9 9999999999 9999 9

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