Consent to Extend the Time to Issue
an Assessment or to File a Claim for Refund
Florida Administrative Code
Consent Agreement #
Business Partner Number
New Expiration Date
Tax and Governing Statute
Statute of Limitations for Statute of Limitations
Sales and Use Tax and any other applicable
surtax(es), Chapter 212, F.S.
Corporate Income Tax, Chapter 220, F.S.
Intangible Personal Property Tax, Chapter 199, F.S.
Documentary Stamp Tax, Chapter 201, F.S.
Communications Services Tax, Chapter 202, F.S.
Service Notification Number(s)
The taxpayer and the Florida Department of Revenue consent, with respect to the tax(es) and period(s) specified above, that assessments or claims
for refunds may be filed at any time on or before the new statute of limitations (SOL) date indicated above. This consent to extend the statute of
limitations includes tax liabilities or refunds for which the taxpayer is or may be responsible because of merger, consolidation, or transferee liability.
This consent will not deprive the taxpayer of any appeal rights to which the taxpayer would otherwise be entitled.
An authorized person must sign this form. This includes, but is not limited to: an owner, partner, officer, authorized member or manager,
trustee, or authorized representative with a Power of Attorney
Printed Name of Authorized Person
Florida Department of Revenue Designee
Printed Name of FDOR Designee
Statutory Authority: Section 213.23(1), F.S., provides that, "The executive director of the department or his or her designee may enter into agreements with taxpayers
which extend the period during which an assessment may be issued or a claim for refund may be filed with respect of any tax, license, or fee collected by the
Department of Revenue. Notwithstanding provisions of s. 95.091 or s. 215.26 to the contrary, if, before the expiration of time prescribed in a revenue law of this state for
issuance of an assessment or claim of a refund, both the department and the taxpayer have consented in writing to the issuance of an assessment or claim of a refund
after such time, an assessment may be issued or a claim for refund may be made at any time prior to the expiration of the period agreed upon.
The period so agreed upon may be extended by subsequent agreements made before the expiration of the period previously agreed upon."