Form Dr-157b - Fuel Tax Cash Bond

ADVERTISEMENT

MAIL TO:
DR-157B
ACCOUNT MANAGEMENT - FUEL UNIT
Fuel Tax Cash Bond
R. 11/10
FLORIDA DEPARTMENT OF REVENUE
PO BOX 6480
TALLAHASSEE, FL 32314 - 6480
Please complete and submit a separate bond form for each fuel product type or taxable pollutant. Importers must
provide a separate bond form as surety for the required “Importer’s Additional Bond”. An applicant cannot be issued a
fuel license by the Department of Revenue until the proper surety is submitted. If further information is needed, please
contact Account Management at 800-352-3671.
❑
Motor Fuel License No. ______________________________________
❑
Diesel Fuel License No. ______________________________________
❑
Aviation Fuel License No. ____________________________________
❑
Pollutant Tax License No. ____________________________________
❑
Importer’s License No. _______________________________________
❑
Wholesaler of Alternative Fuel License No. ____________________________________
Amount $ _________________________________
This is a cash bond or deposit made by the person or firm shown below to secure and guarantee payment of:
(
) Motor Fuel pursuant to Chapter 206, Florida Statues (
) Pollutant Tax pursuant to Chapter 206, F.S.
(
) Diesel Fuel pursuant to Chapter 206, F.S.
(
) Importer’s Additional Bond pursuant to section 206.051,
F.S.
(
) Aviation Fuel pursuant to Chapter 206, F.S.
(
) Alternative Fuel pursuant to Chapter 206, F.S.
From: _____________________________________________________________________________________________________
Name of Owner
___________________________________________________________________________________________________________
Trade Name
Address: ___________________________________________________________________________________________________
(Street Adress)
___________________________________________________________________________________________________________
(City)
(County)
(State)
(ZIP)
For DOR Use Only
Money Order No.__________________________________
Cashier’s Check No. _______________________________
Accepted this ______ day of ________________, ______ .
(month)
(year)
Certified Check No. _______________________________
Florida Department of Revenue
By _______________________________________________
NOTE: The original bond will be maintained by the
Name
Florida Department of Revenue.
__________________________________________________
Title
Account Number: __________________________________

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Dr-157 - Fuel Tax Surety Bond Form Dr-157 - Fuel Tax Surety Bond Financial
Form 2789 - Motor Fuel Tax Cash Bond - Missouri Department Of Revenue 2006 Form 2789 - Motor Fuel Tax Cash Bond - Missouri Department Of Revenue 2006 Financial
Form 670 - Motor Fuel Tax Surety Bond - Missouri Department Of Revenue - 2005 Form 670 - Motor Fuel Tax Surety Bond - Missouri Department Of Revenue - 2005 Financial
Form 72a071 - Motor Fuels Tax Refund Bond (city And Suburban Bus, Nonprofit Bus, Senior Citizen Transportation, Or Taxicabs) Form 72a071 - Motor Fuels Tax Refund Bond (city And Suburban Bus, Nonprofit Bus, Senior Citizen Transportation, Or Taxicabs) Financial
Form Dr 7118 - Fuel Tax Refund Claim Form Dr 7118 - Fuel Tax Refund Claim Financial
Form Dr 0219 - Cigarette License Surety Bond Form Dr 0219 - Cigarette License Surety Bond Financial
Form Cd-18 - Tobacco Tax Credit Bond Form Cd-18 - Tobacco Tax Credit Bond Financial
Form 72a065 - Aviation Gasoline Tax Refund Bond Form 72a065 - Aviation Gasoline Tax Refund Bond Financial
Form Tc-763wt - Withholding Tax Surety Bond Form Tc-763wt - Withholding Tax Surety Bond Financial
Form Dr 7065 - Fuel Distributors Bond Form Dr 7065 - Fuel Distributors Bond Financial

Related Categories

Parent category: Financial
Download
Go