Form Dr-700001 - Municipal Public Service Tax Database Report

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DR-700001
Municipal Public Service Tax Database Report
R. 01/16
TC
Rule 12B-6.0051
Florida Administrative Code
Effective 01/16
This form is intended to be used to comply with section 166.233(2), Florida Statutes. All Florida municipalities and charter counties must provide this information to the
Florida Department of Revenue, sending changes as they occur. Any change in a tax levy or rate must be reported at least 120 days before the change occurs.
Please fill in all information on each municipal public service not administered by a municipality, or its separate utility authority, board, or commission. (No information is
required for any service administered by a municipality or its separate authority, board, or commission.)
Note: Tax levies for communications services are no longer reported to the Department of Revenue using this form. To report communications service tax levies and levy
changes local officials must use form DR-700021.
Municipality _____________________________________________________________________ County_____________________________________________________________________
Service
New Tax
Effective Date
Government Contact
Telephone
Street/PO Box
City
ZIP Code
Rate**
Person
Gas:
Natural
Liquefied
Petroleum
Manufactured
Electric
Water
Fuel Oil/Kerosene
**Enter tax rate. If existing tax is repealed, enter “0%” for “New Tax Rate”. If voluntarily reporting self-administered tax, enter tax rate and “S/A.”
__________________________________________________
____________________________
_________________________________________________
____________________
Preparer Name
Preparer Phone
Preparer Signature
Date
Return completed form to:
Municipal Public Service Tax Coordinator Coordinator
Phone
850-617-8586
For DOR Use Only
Revenue Accounting MS 1-3600
Fax 850-921-1171
Date Entered _____________________________
Florida Department of Revenue
5050 W Tennessee St
By ______________________________________
Tallahassee FL 32399-0136

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