Form Dr-151 - Blind Person'S Application For Certificate Of Exemption printable pdf download

Form Dr-151 - Blind Person'S Application For Certificate Of Exemption

DR-151

Blind Person’s Application for

R. 03/13

Certificate of Exemption

Office Use Only

BP ___________________

CO __________________

RS _________ N ___ R __

PM Date _____________

This application is for requesting a consumer’s certificate of exemption.

Date Rec'd ___________

This exemption certificate grants the holder a sales and use tax exemption

in Florida for the:

•

Rental or purchase of a “seeing eye” guide dog.

•

Purchase of food and other items for a guide dog.

To be eligible for a consumer’s certificate of exemption, a blind person must first hold an

identification card issued by the Florida Department of Education, Bureau of Blind Services,

certifying the holder as visually impaired. Any blind person holding an identification card issued by

the Department of Education, Bureau of Blind Services will be issued a Consumer’s Certificate of

Exemption for the Blind (Form DR-152). The exemption certificate does not expire.

Applicant’s Name:______________________________________________________________________

Street Address:_________________________________________________________________________

City:__________________________________State:_______________ZIP code:____________________

Mailing Address if Different from Above

Street Address:_________________________________________________________________________

City:__________________________________State:_______________ZIP code:____________________

Identification Card Number for the Identification Card issued by the Florida Department of Education,

Bureau of Blind Services:__________________

This application is for (Check One)

A New exemption certificate:_______ or,

A Reprint of a previously issued exemption certificate:_______.

•

Original Card Number:________________________

Signature:______________________________________________Date:_________________________

Mail Completed Application To:

If you have any questions or need assistance,

Florida Department of Revenue

call 800-352-3671.

Account Management/Exemptions

PO Box 6480

Tallahassee, FL 32314-6480

Form Dr-151 - Blind Person'S Application For Certificate Of Exemption