DR-15EZ
R. 01/20
Rule 12A-1.097, F.A.C.
Effective 01/20
Page 1 of 2
You may file and pay tax online or you may complete this return and pay tax by check or money order and mail to:
Florida Department of Revenue
5050 W Tennessee Street
Tallahassee, FL 32399-0120
Please read the Instructions for DR-15EZ Sales and Use Tax Returns (Form DR-15EZN), incorporated by reference in Rule 12A-1.097, F.A.C., before you complete this return. Instructions are posted at floridarevenue.com/forms.
Florida Sales and Use Tax Return
Reporting Period
Certificate Number:
Surtax Rate:
DR-15EZ
R. 01/20
HD/PM DATE:
Location/Mailing Address Changes:
Your CopyNew Location Address:
Telephone Number: ( )
New Mailing Address:_________________________________________
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FLORIDA DEPARTMENT OF REVENUE |
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5050 W TENNESSEE ST |
Amount Due From Line 9 |
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TALLAHASSEE FL 32399-0120 |
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On Reverse Side |
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Due: |
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Late After: |
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9100 |
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20219999 |
0001003043 |
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4999999999 |
0000 |
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Florida Sales and Use Tax Return |
DR-15EZ |
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Reporting Period |
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R. 01/20 |
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HD/PM DATE: |
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Certificate Number:
Surtax Rate:
Location/Mailing Address Changes:
New Location Address:
Telephone Number: ( |
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New Mailing Address: |
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FLORIDA DEPARTMENT OF REVENUE |
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5050 W TENNESSEE ST |
Amount Due From Line 9 |
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TALLAHASSEE FL 32399-0120 |
On Reverse Side |
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Due: |
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Late After: |
9100 |
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20219999 |
0001003043 |
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4999999999 |
0000 |
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DR-15EZ
R. 01/20
Page 2 of 2
File and Pay Online to Receive a Collection Allowance. When you electronically file your tax return and pay timely, you are entitled to deduct a collection allowance of 2.5% (.025) of the first $1,200 of tax due, not to exceed $30. To pay timely, you must initiate payment and receive a confirmation number, no later than 5:00 p.m. ET on the business day prior to the 20th. More information on filing and paying electronically, including aFlorida eServices Calendar of Electronic Payment Deadlines (Form DR-659), is available at floridarevenue.com.
Due Dates. Returns and payments are due on the 1st and late after the 20th day of the month following each reporting period.
A return must be filed for each reporting period, even if no tax is due.If the 20th falls on a Saturday, Sunday, or a state or federal holiday, returns are timely if postmarked or hand delivered on the first business day following the 20th.
Penalty. If you file your return or pay tax late, a late penalty of 10% of the amount of tax owed, but not less than $50, may be charged. The $50 minimum penalty applies even if no tax is due. A floating rate of interest also applies to late payments and underpayments of tax.
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DOLLARS |
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CENTS |
Under penalties of perjury, I declare that I have read this return and |
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1. |
Gross Sales |
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the facts stated in it are true. |
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(Do not include tax) |
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2. |
Exempt Sales |
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(Include these in |
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Gross Sales, Line 1) |
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Signature of Taxpayer |
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Telephone # |
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3. |
Taxable Sales/Purchases |
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(Include Internet/Out-of-State |
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Purchases) |
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Signature of Preparer |
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Telephone # |
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4. |
Total Tax Due |
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(Include Discretionary Sales Surtax |
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from Line B) |
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5. |
Less Lawful Deductions |
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Discretionary Sales Surtax Information |
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A. Taxable Sales and |
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6. |
Less DOR Credit Memo |
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Purchases NOT Subject |
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to DISCRETIONARY |
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SALES SURTAX |
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7. |
Net Tax Due |
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B. Total Discretionary |
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8. |
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Less Collection Allowance or |
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Sales Surtax Due |
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Plus Penalty and Interest |
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E-file / E-pay to Receive Collection Allowance |
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9. |
Amount Due With Return |
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Please do not fold or staple. |
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(Enter this amount on front) |
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DOLLARS |
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CENTS |
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Under penalties of perjury, I declare that I have read this return and |
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1. |
Gross Sales |
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the facts stated in it are true. |
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(Do not include tax) |
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2. |
Exempt Sales |
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(Include these in |
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Gross Sales, Line 1) |
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Signature of Taxpayer |
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Telephone # |
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3. |
Taxable Sales/Purchases |
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(Include Internet/Out-of-State |
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Purchases) |
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Signature of Preparer |
Date |
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Telephone # |
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4. |
Total Tax Due |
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(Include Discretionary Sales Surtax |
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from Line B) |
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5. |
Less Lawful Deductions |
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Discretionary Sales Surtax Information |
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A. Taxable Sales and |
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6. |
Less DOR Credit Memo |
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Purchases NOT Subject |
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to DISCRETIONARY |
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7. |
Net Tax Due |
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SALES SURTAX |
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B. Total Discretionary |
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8. |
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Less Collection Allowance or |
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Sales Surtax Due |
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Plus Penalty and Interest |
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E-file / E-pay to Receive |
Collection |
Allowance |
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9. |
Amount Due With Return |
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, |
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Please do not fold or staple. |
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(Enter this amount on front) |
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