Form Dr-309632 Draft - Wholesaler/importer Fuel Tax Return - 2018
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1400001 0000001
DR-309632
Wholesaler/Importer Fuel Tax Return
R. 01/14
Page 1
2018
For Calendar Year
TC
Rule 12B-5.150
Florida Administrative Code
Effective 01/14
Handwritten Example
Typed Example
0 1 2 3 4 5 6 7 8 9
0123456789
Use black ink.
IMPORTANT
Complete and return
coupon to the Department
of Revenue.
COMPLETE FORM DR-309632
BEFORE ENTERING INFORMATION
ON THE ATTACHED COUPON.
Mail the original of this form along with coupon
to the:
Florida Department of Revenue
5050 W Tennessee St
Tallahassee FL 32399-0165
Detach
Detach
here
here
Wholesaler/Importer Fuel Tax Return Coupon
Mail To:
DR-309632
Florida Department of Revenue
2018
R. 01/14
For Calendar Year:
5050 W Tennessee St
COMPLETE and MAIL with your RETURN/PAYMENT.
Tallahassee FL 32399-0165
Please write your Federal Employer Identification Number (FEIN) on check.
Be sure to SIGN YOUR CHECK.
Make check payable to: Florida Department of Revenue
FEIN
ENTER BUSINESS NAME:
US Dollars
Cents
AMOUNT DUE
,
,
FROM LINE 30
Name
IF CREDIT DUE ENTER 0
Address
City/St/ZIP
FOR COLLECTION
M M D D
Y
Y
PERIOD ENDING
DR-309632
Do Not Write in the Space Below.
9200 0 20189999 0092027032 3 3000000001 0000 2
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