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DR-370060

Refund Sampling Methodology Application

N. 10/02

Page 1

FOR DOR USE ONLY

Approval # _______________________________________________

Approved (date) ___________________

PART I – all of Part I is REQUIRED and must be completed

Also reference Rule 12-26, F.A.C.

The submission of this application will not toll the statute of non-claim. However, filing an Application for Refund (Form

DR-26S) with the Department will toll the statute for refund. Complete Part 1 and Part II or Part III and attach appropriate

documentation. Part IV must be completed and signed, as appropriate, or the form is not complete. Type or print clearly.

QUESTIONS

INFORMATION/GUIDELINES

Name of applicant/payee:

Provide the name, address and

contact numbers of the applicant/

payee. Payee is the person (entity)

Mailing address:

City, State, ZIP:

that remitted tax payment to the

Department. If the applicant is not

Location address (other than above):

City, State, ZIP:

the payee, an assignment of rights

should be included with the refund

Business telephone number (include area code):

Home telephone number (include area code):

documentation.

(

)

(

)

Fax number including area code (optional):

E-mail address (optional):

(

)

Provide the Sales Tax Registration

Sales tax registration number:

Number for the applicant requesting

the refund.

Indicate the collection period and

(1) Collection Period: _________________________________________________________

date taxes were remitted to the

Note: Do not include period(s) outside the statute of limitation for refund.

Department.

(2) Date sales tax was paid to the Department _____________________________________

(1) Certified Audit Program: This option requires registration in the Certified Audit Program

Indicate which sampling approach

pursuant to s. 213.285, F.S. All required forms and documentation shall be provided

you will be using by checking one of

through the qualified practitioner as provided in Rule 12-25.051, F.A.C. (Mail the Refund

the boxes below:

Sampling Methodology Application and other information directly to Certified Audit.)

❏ (1) Certified Audit Program

FLORIDA DEPARTMENT OF REVENUE

CERTIFIED AUDIT SUBPROCESS

❏ (2) C. P. A. Attestation

SOUTHWOOD 3RD FL

❏ (3) Department of Revenue

PO BOX 5139

TALLAHASSEE FL 32399

Approved Methodology

(2) C. P. A. Attestation: All sampling methods under this option, whether statistical or non-

Note:

statistical, will be performed in accordance with Rule 12-26.0041, F.A.C. Refund requests

All sampling methods, whether

using a sampling method conducted through attestation by a certified public accountant

statistical or non-statistical, will be

pursuant to the authority of s 212.12(6)(c)3., F.S., are attestation engagements that are

conducted under Statements on Standards for Attestation Engagements, #10 – Agreed

performed in accordance with Rule

Upon Procedures. Any non-statistical sampling method must be agreed upon and

12-26.0041, F.A.C.

approved in writing by the Department. A taxpayer that elects to conduct the sample by

attestation by a Certified Public Accountant should attach a properly executed Power of

Attorney (Form DR-835).

(3) Department of Revenue Approved Methodology: All methodology whether statistical or

non-statistical under this option must be approved by the Department in writing prior to a

refund being granted.

Name of person(s) planning and/or conducting the sample Degree(s) earned:

If you have selected (2) or (3) in

question D above, complete this

Title:

Business telephone number (include area code):

step. Provide the name, title and

telephone number of person(s)

planning and/or conducting the

Attach documentation of the source(s) of sampling training, course name(s), curriculum,

sample including degrees earned.

date(s) of completion or attach a copy of the certificate of completion from the Department of

Revenue sampling training course. A taxpayer that elects to conduct the sample through a

representative should attach a properly executed Power of Attorney (Form DR-835). For more

information about the Department of Revenue sampling training course, contact the Refunds

Subprocess at 850-488-8937.

In your response, describe why the records you have chosen should be sampled

Explain why you are sampling.

instead of detailed. Describe the advantages of sampling these records.

Form Dr-370060 Instructions - Refund Sampling Methodology Application For Sales And Use Tax Page 2

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