Form Dr-1 - Florida Business Tax Application Page 3
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10DR-1
R. 01/15
Page 3
BUSINESS BACKGROUND INFORMATION
13. Has this business entity ever been known by
If yes, provide previous name:
Yes
No
another name?
14. Has this business entity ever been issued a certificate of registration, certificate number or tax account number by the Florida Department
Yes
No
of Revenue?
15. Has any owner/proprietor, partner, officer, member, trustee, or the person whose social security number is provided in items 8c or 12 ever
Yes
No
been issued a certificate of registration, certificate number or tax account number by the Florida Department of Revenue?
16. If you answered “Yes” to questions 14 or
a.
Name of person or entity named on certificate of registration:
15, provide the name, address and certificate
b.
Address of person or entity named on certificate of registration:
of registration number for each business,
proprietor, owner, partner, officer, member or
c.
Certificate or tax account number:
trustee.
17. Has a tax warrant ever been filed by the Florida Department of Revenue against this business entity?
Yes
No
18. Has a tax warrant ever been filed by the Florida Department of Revenue against any owner/proprietor, partner, officer, member, trustee, or the person
Yes
No
whose social security number is provided in items 8c or 12?
BUSINESS ACTIVITIES DESCRIPTION
19a. Describe the primary nature of your business and list all activities,
products, and services. Include all of your taxable activities if known.
19b. If known, provide your North American Industry Classification System (NAICS) Code(s). Enter your primary code first. To determine your NAICS code, go
to
Primary Code:
Section B – Activities Subject to Sales & Use Tax
($5 fee for in-state business/rental locations)
General
20.
Does your business (check the yes or no box next to each activity with black or blue pen):
Yes
No
Y
N
a. Sell products or services at retail (to consumers)?
Y
N
b. Sell products or services at wholesale (to registered dealers who will sell to consumers)?
Y
N
c. Purchase or sell secondhand goods (see description in the Sales and Use Tax section of the instructions, Form DR-1N)? If you consign, buy or trade secondary
goods, in addition to registering for sales and use tax, complete and submit a Registration Application for Secondhand Dealers and/or Secondary Metals Recyclers
(Form DR-1S).
Y
N
d. Purchase or sell salvage or scrap metal to be recycled? If you obtain, purchase or convert ferrous or nonferrous metals into raw material products, in addition to
registering for sales and use tax, complete and submit a Registration Application for Secondhand Dealers and/or Secondary Metals Recyclers (Form DR-1S).
Y
N
e. Sell products or goods from nonpermanent locations (such as flea markets or craft shows)?
Y
N
f. Sell products or goods by mail order using catalogs or the Internet?
Y
N
g. Rent or lease commercial real property to individuals or businesses?
Y
N
h. Rent or lease living or sleeping accommodations to others for periods of six months or less?
Y
N
i. Manage the rental or leasing of living or sleeping accommodations belonging to others?
Y
N
j. Rent equipment or other property or goods to individuals or businesses?
Y
N
k. Repair or alter consumer products or equipment?
Y
N
l. Charge admission or membership fees?
Y
N
m. Place and operate coin-operated amusement machines at business locations belonging to others?
Y
N
n. Place and operate food or beverage vending machines at business locations belonging to others?
Y
N
o. Place and operate nonfood or nonbeverage vending machines at business locations belonging to others?
Y
N
p. Operate vending machines at your business location(s)?
Y
N
q. Purchase items that you will include in a finished product assembled or manufactured for sale?
Item 20 continues on Page 4
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