Form Dr-29 - Florida Sales And Use Tax Application For Release Or Refund Of Security
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1DR-29
Florida Sales and Use Tax
R. 03/10
Application for Release or Refund of Security
Rule 12A-1.097
Florida Administrative Code
Effective 06/10
SECURITY INFORMATION:
Type of Security Posted (Check only one.)
q Cash Deposit/Cash Bond
q Surety Bond
q Irrevocable Letter of Credit
Date Security Posted
Amount of Security
Certificate No.
Federal Employer Identification Number
Business Partner/Certificate Holder
Mailing Address
City
County
State
ZIP Code
RELEASE/REFUND JUSTIFICATION:
Check all that apply:
q The Business Partner/Certificate Holder has complied with the provisions of Chapter 212, F.S., for a period of
twelve consecutive months, beginning _________________________ and ending _________________________.
q The Business Partner/Certificate Holder has complied with the terms and conditions of the compliance agreement
entered into with the Department on this date: ____________________________.
q The Business Partner’s/Certificate Holder’s business operations have ceased as of this date:
____________________________.
NOTE FOR BUSINESS PARTNERS/CERTIFICATE HOLDERS THAT CEASE OPERATIONS:
•
A final return with applicable tax payment must accompany this application.
•
Your original Certificate of Registration and Annual Resale Certificate must be surrendered with this
application.
•
Your certificates will be cancelled as of the date entered above.
APPLICANT CERTIFICATION
Under penalties of perjury, I declare that I have read the foregoing application and the facts stated in it are true. I
understand that if the Business Partner/Certificate Holder later resumes business activities requiring registration
with the Department of Revenue, the Business Partner/Certificate Holder may be required to post similar security as
condition of obtaining a certificate of registration.
________________________________________________________________________
_________________________
Signature of Owner(s), Partner, Corporate Officer or Member
Date
DEPARTMENT VERIFICATION:
q Release/refund entire amount of security.
q Apply $ _____________________________ to Certificate No. __________________________ Period: _______________
For the Department: _________________________________________________________________ Date: _______________
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