Form Dr-1 - Florida Business Tax Application Page 4
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10DR-1
R. 01/15
Page 4
20.
Does your business (check the yes or no box next to each activity with black or blue pen):
Y
N
r. Purchase items for use in your business that were not taxed by the seller when purchased (includes purchases through catalogs, the Internet, or from out-of-state
vendors)?
Y
N
s. Use dyed diesel fuel for off-road purposes?
Y
N
t. Provide any of the following services? If yes, check the box next to each service you provide.
(1) Pest control services for nonresidential buildings
(4) Protection services
(2) Interior cleaning services for nonresidential buildings
(5) Security alarm system monitoring services
(3) Detective services
Coin-Operated Amusement Machines
Y
N
21. Are coin-operated amusement machines operated at your business location? ...........................................................................................................
If yes, answer question a. If no, skip to question 22.
Y
N
a.
Do you have a written agreement designating a party other than the applicant entity as the operator of the amusement machines at your location? .......................
If yes, provide name, address, and telephone number of machine operator: If no, also complete an Application for Amusement Machine Certificate (Form DR-18).
Telephone number: ( )
Name:
Mailing address:
City/State/ZIP:
Real Property Contractors
Y
N
22. Do you improve real property as a contractor? ..............................................................................................................................................................
If yes, answer questions a–d. If no, skip to question 23.
a.
Indicate your industry category(s) (check all that apply):
residential
commercial
industrial
utility
bridge/road
Y
N
b.
Do you sell products at retail? ...............................................................................................................................................................................................................
Y
N
c.
Do you purchase materials/supplies from out-of-state vendors for use in your Florida projects? .......................................................................................................
Y
N
d.
Do you construct or assemble building components away from your project sites? ............................................................................................................................
Motor Fuel Sales
Y
N
23. Do you sell gasoline, diesel fuel, or aviation fuel at posted retail prices? .....................................................................................................................
If yes, complete item a. If no, skip to question 24.
a.
Check the box next to the description that best describes your fuel sales activities.
Gas station only
Gas station/convenience store
Truck stop
Marine fueling
Aircraft fueling
Section C – Activities Subject to Sales Tax and the Prepaid Wireless E911 Fee
Y
N
24. Do you sell prepaid phones, phone cards or calling arrangements? .............................................................................................................................
If yes, check the box next to each activity below that describes your sales.
a. Domestic or international long distance calling/phone cards (non-wireless)
b. Prepaid wireless services (cards, plans, devices) that provide access to wireless networks and interaction with 911 emergency services.
Section D – Activities Subject to Solid Waste Fees & Surcharge
($30 dry-cleaning fee applies)
Y
N
25. Do you sell tires or batteries, or rent or lease motor vehicles to others? ......................................................................................................................
If yes, answer questions a–c. If no, skip to question 26.
Y
N
a.
Do you sell (at retail) new tires for motorized vehicles that are sold separately or as part of a vehicle? .............................................................................................
b. Do you sell (at retail) new or remanufactured lead-acid batteries that are sold separately or as a component part of another product
Y
N
such as new automobiles, golf carts, or boats? .....................................................................................................................................................................................
Y
N
c.
Do you rent, lease, or sell car-sharing membership services for the use of, motor vehicles that transport fewer than nine passengers? ............................................
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Parent category: Financial