Form Dr-1214 - Application For Temporary Tax Exemption Permit Page 2
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1
2(f)
If expansion is claimed, show percent of total qualifying machinery and equipment that will be purchased for each quarter of
each year during expansion.
(Percentage)
(Percentage)
(Percentage)
(Percentage)
Year 1 — Jan. - Mar. ___________
Apr. - June ___________
July - Sept. __________
Oct. - Dec. ___________
Year 2 — Jan. - Mar. ___________
Apr. - June ___________
July - Sept. __________
Oct. - Dec. ___________
Year 3 — Jan. - Mar. ___________
Apr. - June ___________
July - Sept. __________
Oct. - Dec. ___________
(g)
If tax exemption is claimed due to the expansion of an existing facility, please answer the following questions:
(1) How do you propose to measure your increase in productivity? (Specify a unit of measure, i.e., ounces, pounds, tons,
units, pieces, volume, gallons, yards, etc. Selling price or labor hours may not be used.) _________________________
(Specify the rate of production, i.e., per hour, week, month, or year.) _________________________________________
(2) What is your current production output? (Use units of measure and rate.) ____________________________________
(3) What is your expected increase in production output? (Use units of measure and rate.) _________________________
(4) What is the percent increase? _______________________________________________________________________
4. (a)
Is the business entity going to be purchasing ALL of the qualifying machinery and equipment?
Yes
No
(b)
If no, what percent of the machinery and equipment will the business entity be purchasing? __________________________
(c)
Who will purchase the remainder of the machinery and equipment? _____________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
(c)
Is any qualifying machinery and equipment going to be leased?
Yes
No
If yes, will this be a:
Capital Lease
Operating Lease
5.
Please attach a schedule of all contracts awarded on this project showing the contractor’s name and address as well as the
type of contract, its description and amount (forms DR-1207 and DR-1208).
6.
Additional Remarks: __________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Important: A qualifying business entity must file this form if it seeks to make purchases of machinery and equipment tax-exempt or pays
tax at the time of purchase and seeks a refund of those previously paid taxes. No purchases of machinery and equipment
made on or after July 1, 1996, will qualify for exemption unless that business has registered with the WAGES Program prior
to making those purchases. To avoid any delays in obtaining the permit or refund, the application must be fully completed
and returned to: Director, Tax Policy and Dispute Resolution, P.O. Box 7443, Tallahassee, Florida 32314-7443.
________________________________
____________
Signature
Date
________________________________________________
Name (Type or Print)
________________________________________________
Title
For Florida Department of Revenue Use ONLY — Do not write in this space
_____________
The above project is: (check one)
Permit
________________
Approved as a new business
From
To
Approved as expansion business
Approved as a spaceport activity
Refund
Not approved for the exemption
_______________________________
__________
(Signature of Authorized Agent)
Date
Business Name: __________________________________
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