Form Dr-156r Draft - Renewal Application For Florida Fuel/pollutants License Page 6
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7DR-156R
R. 01/18
Page 5
16. Pollutants storage information
Will this business produce, import, or remove petroleum pollutants through a terminal rack in this state? YES
NO
If “YES” (check appropriate box(es)):
Produce
Import or cause to be imported (into Florida)
Export
Be entitled to a refund on the following taxable pollutants:
Petroleum products
Ammonia
Pesticides
Chlorine
Motor oil or other lubricants
Crude Oil
Solvents
Perchloroethylene
Other (specify) _____________________________________________________________________________
List the type of pollutant, location of storage facility, and estimated volume of taxable units imported, produced,
or sold in Florida.
Type of Pollutant
Location of Storage Facility
Taxable Units
17.
Bond information
The license categories shown below usually require a bond. A wholesaler who has no import or export activity that sells
only undyed diesel fuel and that is not authorized by the Department to remit fuel tax to its supplier is not required to
have a bond. An applicant applying for a pollutants tax license for the sole purpose of applying for refunds pursuant to
section 206.9942, F.S., of tax-paid pollutants is not required to post a bond. Please list the information on the bonds
your business currently has secured.
Bond Type
Bond Company Name
Bond Company FEIN
Bond Number
Bond Amount
Motor Fuel
Diesel Fuel
Aviation Fuel
Importer’s Bond
Exporter’s Bond
Pollutants
18. List all suppliers of pollutants.
Name of Supplier
License Number
Licensing Information
19.
Do you wholesale motor, diesel or aviation fuel? __________________________________
NO
YES
20. A) Are you registered to collect and/or remit sales tax? .................................................... YES NO
B) If “YES,” what is your sales tax registration number? _______________________________________
21.
Will this business import fuels into Florida upon which there has been
no prior collection of tax?...................................................................................................
YES
NO
22. Do you blend untaxed products for use as motor fuel, diesel fuel or aviation fuel? ........
YES
NO
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