Form Dr-18 - Application For Amusement Machine Certificate printable pdf download

DR-18

Application for Amusement Machine Certificate

R. 03/06

General Information and Instructions

A COIN-OPERATED AMUSEMENT MACHINE is any machine operated by

LINE-BY-LINE INSTRUCTIONS

coin, slug, token, coupon, or similar device for the purpose of entertainment

Sales and use tax registration number: Enter the sales tax

or amusement. Amusement machines include but are not limited to:

number of the “operator.” If you do not have a sales tax number,

coin-operated radio and televisions, telescopes, pinball machines, music

you must first obtain one by completing the Application to Collect

machines, juke boxes, mechanical rides, video games, and all other similar

and/or Report Tax in Florida (Form DR-1). If you have machines in

amusement devices.

multiple counties, a separate DR-18 must be filed for each county.

CERTIFICATE REQUIRED TO BE DISPLAYED. Any sales tax dealer that

Consolidated sales tax filers will place their consolidated number

is registered or is required to be registered, who is an “operator” of coin-

here. Enter this number at the top of page 4 also.

operated amusement machines which are operated in Florida, must apply

Name of operator: Enter name of operator. If the operator is a

for an Amusement Machine Certificate (Form DR-18C). Every physical

corporation, enter corporate name. Enter this name also at the top of

location where coin-operated amusement machines are in operation must

page 4.

display a certificate authorizing the operation of a specified number of

machines.

Business name of operator: Enter the name of the business

determined to be the operator.

OPERATOR IS REQUIRED TO PURCHASE CERTIFICATE

Business Proprietor - The business proprietor shall be deemed to be

Operator’s mailing address: Enter the mailing address of the

the lessee and operator of the machines, unless otherwise provided in a

operator. Certificates and renewal notices will be mailed to this

written agreement between the business proprietor and the machine owner.

address only.

As “operator,” the business proprietor is responsible for suitable record

5a.

Daytime telephone number: Enter the area code and telephone

keeping and is liable for the tax on machine receipts (4%, 4.25%, 4.5%,

number of the person to be contacted if the Department has

5%, or 5.5% depending on discretionary surtax per county); the annual $30

questions regarding this completed application.

per machine certificate fee; and the tax paid on the lease of each machine

(6%, 6.25%, 6.5%, 7%, or 7.5% depending on discretionary surtax per

5b.

E-mail: Enter current e-mail address.

county).

Certification by operator or operator’s authorized representative:

However, if there is a written agreement, it is suggested that it designate:

Read carefully and sign. This application will be returned if not

signed by the operator or the operator’s authorized representative.

• who is responsible for record keeping and remitting the tax on

machine receipts;

7-9. Complete separate section for each location where machines are

operated.

• who is the “operator” (this person is responsible for paying the

certificate fee); and

Location business name: If business name where machine(s) is

(are) located is different from number 3 above, provide the complete

• whether the arrangement is a lease of tangible personal property or

name.

a lease of real property.

Physical Address: Enter the complete physical address where the

Machine Owner - If a person who owns amusement machines is also the

machine(s) is (are) located (DO NOT USE A POST OFFICE BOX).

proprietor of the business where the machines are operated, such person

is deemed to be the “operator,” and is responsible for suitable record

Maximum number of machines: Enter the actual number of

keeping and is liable for the tax on machine receipts (4%, 4.25%, 4.5%,

machines operated/to be operated at this location. You may not

5%, or 5.5% depending on discretionary surtax per county); the annual $30

place more machines at a location than are shown on the certificate.

per machine certificate fee; and the tax on machine purchases, parts and

Check one: If you are applying for the first certificate for this

repairs (6%, 6.25%, 6.5%, 7%, or 7.5% depending on discretionary surtax

location, check “new location.” Enter the number of machines and

per county).

multiply by $30. This is the fee amount that is due for this location.

HOW IS THE CERTIFICATE FEE CALCULATED? The annual certificate

If you are adding machines to a previously issued certificate, check

fee is $30 per machine and is based on the maximum number of machines

“update” and give amusement machine certificate number. Enter the

operated at a location. Certificates are valid for the period July 1 to June

number of additional machines and multiply by $30. This is the fee

30 each year. The annual fee is non-refundable and will not be prorated

amount that is due for this location.

based on the time of year the certificate is purchased.

10.

Summary of fee(s) paid: Add all new machines on this application

WHERE DO I FILE THIS APPLICATION AND REQUIRED FEE? The

and enter total here. Multiply total by $30. Enter this dollar amount.

Application for Amusement Machine Certificate (Form DR-18) along with

This is the total fee due with this application. Make checks payable

to Florida Department of Revenue.

the required $30 per machine fee may be mailed to: Application for

Amusement Machine Certificate - Room 1-5600, Florida Department of

Revenue, 5050 west Tennessee Street, Tallahassee, Florida 32399-0156,

or may be hand-delivered to the DOR service center closest to you (see the

listing on the back page of these instructions).

*DO NOT SEND CASH*

WHAT IF I WANT TO OPERATE MORE MACHINES THAN ARE LISTED

For further assistance, contact Account Management at

ON AN AMUSEMENT MACHINE CERTIFICATE? The certificate

800-352-3671 or the nearest service center.

authorizes the “operator” to operate a specified maximum number of

amusement machines on a premise. If you wish to operate more than the

number listed on the certificate, you must apply to the Department for a

new certificate. The charge is $30 multiplied by the number of additional

machines you wish to add to your operation at that location.

Form Dr-18 - Application For Amusement Machine Certificate

Related Articles

Related forms

Related Categories