Florida Business Tax ApplicationPlease read the Instructions for Completing the Florida Business Tax Application (Form DR-1N). Every applicant must complete Sections A and K and must answer the questions in bold print at the beginning of every section and subsection. This application will be rejected if the required information is not provided. Section A 226 Reason for Applying and Applicant Information þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ a. þ New business entity (not previously þ þ Beginning date of Florida taxable business activity: þ þ­ b. þ New/additional Florida business location. Beginning date of business activity at new Florida location: þ þ­ þ Link new location to existing þ þ en8 0en en226en en en en en en en en en en en en226en c. þ New taxable activity at previously registered business location. Date of new taxable activity: þ þ­ þ þ þ þ en en en226en en en en en en en en en en en en226en d. þ Change of Florida county. Date of location county change: þ þ­ þ þ þ number: en en en226en en en en en en en en en en en en226en þ Link new county location to þ þ þ en8 0en en226en en en en en en en en en en en en226en e. þ Change of legal entity/business structure. Date of legal change: þ þ­ þ þ þ þ en en en226en en en en en en en en en en en en226en f. þ Purchase/acquisition of existing business from another person or entity.Date of purchase/acquisition: þ þ­ 2 . þ Is this a seasonal business? en Yes en No þ If yes þ þ þ þ þ þ þ þ BUSINESS ENTITY INFORMATION 3a. þ Legal name of individual owner þ þ þ Last name:First name:Middle name/initial: 3b. þ Owner222s telephone number: þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ 5b. þ Business telephone number: þ þ City/State/ZIP: County: 5c. þ Fax number: þ 6. þ Mail to the attention of: þ þ þ þ þ þ þ City/State/ZIP: 7. þ Email address: þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ 8a. þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ proprietor. Sole proprietors employing workers must also have an FEIN. 8b. þ FEIN: DR-1R. 01/18Page 1Rule 12A-1.097Florida Administrative CodeEffective 04/18 For DOR Use Only Register online at037oridarevenue.com It222s convenient, free,secure and saves paper, postage, and time. American LegalNet, Inc. www.FormsWorkFlow.com þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ other person or entity: a. þ Legal name of person or entity: b. þ FEIN: c. þ Reemployment tax account number: þ þ þ þ þ þ þ f. þ Portion of business acquired: en All en Part en Unknown g. þ Date of purchase or acquisition: h. þ Was the business operating at the time of purchase/ acquisition? en Yes en No i. þ If no þ þ þ þ þ þ þ þ­ j. þ Did the business have employees at the time of purchase/acquisition? en Yes en No k. þ If yes þ þ þ þ þ en Yes en No þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ en Yes en NoBUSINESS STRUCTURE & OWNERSHIP þ þ þ þ þ þ þ þ þ þ þ a. Sole proprietorship þ þ þ þ þ Married couple þ þ General partnership þ þ Limited partnership þ þ Joint venture þ þ þ þ þ þ C-corporation þ þ þ S-corporation þ þ þ þ þ þ þ Single member LLC þ þ þ þ þ Multi-member LLC en þ þ þ þ þ þ þ þ þ þ þ þ þ þ purposes. þ e. Business trust þ f. Nonbusiness trust/Fiduciary þ g. Estate þ Provide date of death: þ þ h. Government agency þ þ þ þ þ þ þ þ þ þ a. þ Document number issued by the Florida Secretary of State when the entity was chartered or authorized to conduct business in Florida:Document number: þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Note: The person signing this application must be listed here.Name: þ þ þ Home address:Percent of ownership/control:Title:Driver license number/Issuing state:City/State/ZIP:Telephone number: þ Name: þ þ Home address:Percent of ownership/control:Title:Driver license number/Issuing state:City/State/ZIP:Telephone number: þ Name: þ þ þ Home address:Percent of ownership/control:TitleDriver license number/Issuing state:City/State/ZIP:Telephone number: þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ and þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ DR-1R. 01/18Page 2 American LegalNet, Inc. www.FormsWorkFlow.com DR-1R. 01/18Page 3BUSINESS BACKGROUND INFORMATION 13. þ Has this business entity ever been known by another name? en Yes en NoIf yes, provide previous name: þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ of Revenue? en Yes en No þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ en Yes en No þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ trustee. þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ en Yes en No þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ whose social security number is provided in items 8c or 12? en Yes en NoBUSINESS ACTIVITIES DESCRIPTION þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ to þ Primary Code: þ þ þ þ þ þ þ General þ Yes þ No Y þ N þ þ þ þ þ þ þ Y þ N þ þ þ þ þ þ þ þ þ þ þ þ þ Y þ N þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Registration Application for Secondhand Dealers and/or Secondary Metals Recyclers þ Y þ N þ d. þ Purchase or sell salvage or scrap metal to be recycled? If þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Registration Application for Secondhand Dealers and/or Secondary Metals Recyclers þ þ Y þ N þ þ þ þ þ þ þ þ þ þ þ þ þ Y þ N þ f. þ Sell products or goods by mail order using catalogs or the Internet? Y þ N þ g. þ Rent or lease commercial real property to individuals or businesses? Y þ N þ h. þ Rent or lease living or sleeping accommodations to others for periods of six months or less? Y þ N þ i. þ Manage the rental or leasing of living or sleeping accommodations belonging to others? Y þ N þ j. þ Rent equipment or other property or goods to individuals or businesses? Y þ N þ k. þ Repair or alter consumer products or equipment? Y þ N þ l. þ Charge admission or membership fees? Y þ N þ m. þ Place and operate coin-operated amusement machines at business locations belonging to others? Y þ N þ n. þ Place and operate food or beverage vending machines at business locations belonging to others? Y þ N þ o. þ Place and operate nonfood or nonbeverage vending machines at business locations belonging to others? Y þ N þ þ þ þ þ þ Y þ N þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Section B 226 Activities Subject to Sales & Use Tax þ (no fee) American LegalNet, Inc. www.FormsWorkFlow.com DR-1R. 01/18Page 4 Section D 226 Activities Subject to Solid Waste Fees & Surcharge þ (no fee) þ Y þ N þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Y þ N þ s. þ Use dyed diesel fuel for off-road purposes? Y þ N þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Coin-Operated Amusement Machines þ þ. ........................................................................................................... Y N þ If yes þ þ þ þ If no þ þ þ þ a. þ Do you have a written agreement designating a party other than the applicant entity as the operator of the amusement machines at your location? þ. ....................... Y N þ If yes þ þ þ þ þ þ þ þ þ þ If no þ þ þ þ þ þ Name: þ þ þ Mailing address:City/State/ZIP:Real Property Contractors þ þ. .............................................................................................................................................................. Y N þ If yes þ þ þ þ If no þ þ þ þ þ þ þ þ þ þ þ þ residential commercial industrial utility bridge/road b. þ Do you sell products at retail? þ. ............................................................................................................................................................................................................... Y N c. þ Do you purchase materials/supplies from out-of-state vendors for use in your Florida projects? þ. ....................................................................................................... Y N d. þ Do you construct or assemble building components away from your project sites? þ. ............................................................................................................................ Y N Motor Fu