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DR-350907

R. 10/13

Page 2

Instructions for Completing Form DR-350907

Who must use this form?

as provided under Chapter 175, Florida Statutes. If the

answer is “yes,” enter the name of the jurisdiction in the

Special Fire Control Districts participating in the Local

space provided.

Insurance Premium Tax associated with a Firefighters’

Pension Trust Fund under Chapter 175, Florida Statutes

Step 4. Obtain authorization. If the change to the

must use Form DR-350907 to notify the Department of

database affects only your jurisdiction, complete Part

Revenue (DOR) of jurisdiction changes.

A of the Official Authorization section. If the change

affects a participating municipality or another Special Fire

Note: All jurisdiction change requests must be

Control District participating in providing pension benefits

submitted using the Department of Revenue’s website

to firefighters as provided under Chapter 175 Florida

at:

Competent

Statutes, complete Parts A and B. To facilitate processing

evidence for the jurisdiction change must be submitted

of address database changes, the local jurisdiction

with this form.

requesting the change should attempt to obtain the

Section 175.101(1), Florida Statutes states that the

written consent of the affected jurisdiction (signature in

local insurance premium tax is imposed only on policies

Part B). The name of the authorizing official should be

covering property “within the corporate limits of such

the address database contact person for that jurisdiction.

municipalities or within the legally defined boundaries of

Participating Special Fire Control Districts can access a

special fire control districts, respectively.”

list of contact persons on the Internet at

Changes submitted online without filing this form and

pdf. Special Fire Control Districts can also call the

the proper competent evidence attachments will not be

Department’s Local Government Unit at 850-717-6630

considered.

for this information. Complete Part C only if you have

How to submit jurisdiction changes?

attempted to obtain the signature of the authorizing

official and have been unable to do so.

Step 1. Set up online access. The fastest and easiest

way to submit jurisdiction changes is online at:

Step 5. Attach competent evidence to this form. Mark

. Register and

each piece of evidence with the online case number.

create your profile for review and approval.

Some examples of competent evidence are:

Step 2. Submit changes online. There are two ways

• Ordinance

to submit jurisdiction changes: 1) by uploading your

• Annexation approval

database of addresses; or 2) by downloading your

• Permit(s)

jurisdiction’s address from the Department’s database

and after reviewing and correcting the addresses, upload

For online submissions, GIS-data files are also

the corrected file back into the system. The changes

considered competent evidence.

will be processed and compared to existing addresses

in the database to produce a Project and related cases

Step 6. Submit Form DR-350907 (with competent

for the jurisdiction. If your city is participating in the local

evidence attached) to DOR.

insurance premium tax for the firefighters’ pension fund,

the appropriate fire district information will be added to

Submit your completed information and all competent

addresses systematically. Special Fire District codes must

evidence online at

be added manually. When the Project is successfully

, or by e-mail,

submitted, you will receive notification from the Local

fax, or mail to the Florida Department of Revenue’s Local

Government Unit of its status. If the Project is approved

Government Unit at:

for release, jurisdictions will be notified to review and

approve the updates.

Email:

Step 3. Complete Form DR-350907. Enter the name of

Fax:

850-921-4711

the jurisdiction initiating the change and the effective date

of the change. Changes must be provided by September

Mail to: Florida Department of Revenue

3rd each year. Enter the project and case number you

Local Government Unit

received online. These are assigned by the Department’s

PO Box 6530

address database once change records are submitted.

Tallahassee, FL 32314-6530

Check the box that corresponds to the type of jurisdiction

change and indicate whether the change affects a

For more information, call the Department’s Local

municipality or another Special Fire Control District

Government Unit at 850-717-6630 or e-mail to:

participating in providing pension benefits to firefighters

Form Dr-350907 Draft - Local Insurance Premium Tax Special Fire Control Districts Notification Of Jurisdiction Change Page 2

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