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DR-116200

R. 01/18

Page 2

For transfers of sales and use tax or the

Sales and Use Tax (enter certificate number):

excise tax on liquor beverages, wine

Excise Tax on Liquor Beverages (enter license number):

beverages, or malt beverages, indicate the

Excise Tax on Wine Beverages (enter license number):

certificate number or license number of the

business receiving the transfer.

Excise Tax on Malt Beverages (enter license number):

Part III - Transferring Business Certification -

Only an authorized officer of the transferring business may sign this notice.

I understand that section (s.) 1002.395(5)(f), Florida Statutes (F.S.), requires the Florida Department of Revenue to provide a copy of any

approval or denial it issues with respect to this application for transfer to the nonprofit scholarship-funding organization indicated on the

associated application for an allocation of credit.

Under penalties of perjury, I certify that the Transferring Business and the Receiving Business are both members of the same affiliated group

of corporations. I understand that the Florida Department of Revenue will provide information regarding the transfer of a tax credit allocation

or a tax credit authorized under the Florida Tax Credit Scholarship Program to the Receiving Business. I declare that I have read the

foregoing Notice and the facts stated in it are true.

Signature of Authorized Officer of Transferring Business

Title

Printed Name of Authorized Officer

Date

Instructions for Florida Tax Credit Scholarship Program

Notice of Intent to Transfer a Tax Credit

• Tax credit allocations for which contributions have been

To transfer a tax credit or a tax credit allocation under the Florida

Tax Credit Scholarship Program both parties to the transfer must be

made to an eligible nonprofit scholarship-funding

members of the same affiliated group of corporations.

organization, but the tax credit has not been claimed on

a tax return.

The transferring member must notify the Department of any tax

• Tax credit amounts approved for carryforward that have

credit transfer prior to the receiving member reporting the tax credit

not been claimed on a tax return.

on a tax return. A separate notice must be submitted for each

member of an affiliated group of corporations receiving a transfer.

A transferred tax credit may only be used against the same tax as

The completed notice must be signed by an officer authorized to

the original tax credit approved by the Department. For example,

sign on behalf of the transferring business. Mail the completed and

if the transferring member received a sales and use tax credit

signed notice to:

allocation, the receiving member may only use the transferred tax

credit as a sales and use tax credit.

Florida Department of Revenue

Revenue Accounting

Members receiving a tax credit allocation must make a

PO Box 6609

contribution to an eligible nonprofit scholarship-funding

Tallahassee FL 32314-6609

organization during the same period that the transferring member

was required to make the contribution. The contribution must be

The Department of Revenue will send written approval regarding the

made before the member may claim the tax credit.

amount of the tax credit transferred within fifteen (15) days after

receipt of a completed notice. You must have a letter from the

A transferred tax credit may only be taken by the receiving

Department approving the credit transfer prior to claiming the tax

member of the affiliated group during the same period that the

credit on a tax return.

transferring member was approved to take the tax credit.

The following tax allocations or tax credits may be transferred from

A transferred carryforward amount may only be taken as a tax

one member of an affiliated group to another member of the same

credit during the same time period as the transferring member

affiliated group:

was authorized to take the carryforward tax credit amount.

• Tax credit allocations prior to making a contribution to an

eligible nonprofit scholarship-funding organization.

References: Section 1002.395(5)(d), Florida Statutes; Rule Chapter 12-29, Florida Administrative Code

Form Dr-116200 - Florida Tax Credit Scholarship Program Notice Of Intent To Transfer A Tax Credit Page 2

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