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                                                                                                                                           DR-15
                              Sales and Use Tax Return                                                                                     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-15 Sales and 
                                                                                              Use Tax Returns (Form DR-15N), incorporated 
                                                                                              by reference in Rule 12A-1.097, F.A.C., before 
                                                                                              you complete this return. Instructions are posted 
                                                                                              at floridarevenue.com/forms. 

Certificate Number:                        Sales and Use Tax Return                        HD/PM Date:            /             /          DR-15 R. 01/20
        Florida               1. Gross Sales 2. Exempt Sales                               3. Taxable Amount                               4. Tax Due
A. Sales/Services/Electricity              .                  .                                                       .                              .
B. Taxable Purchases          Include use tax on Internet / out-of-state untaxed purchases                            .                              .
C. Commercial Rentals                      .                  .                                                       .                              .
D. Transient Rentals                       .                  .                                                       .                              .
E. Food & Beverage Vending                 .                  .                                                       .                              .
                                                                                           5. Total Amount of Tax Due
                              Surtax Rate:   Reporting Period                                                                                        .
                                                                                           6. Less Lawful Deductions                                 .
                                                                                           7. Net Tax Due                                            .
Name
Address                                                                                    8. Less Est Tax Pd / DOR Cr Memo                          .
City/St                                                                                    9. Plus Est Tax Due Current Month                         .
   ZIP
                              Your Copy10. Amount Due                                                                                                .
        FLORIDA DEPARTMENT OF REVENUE                                                      11. Less Collection Allowance     E-file/E-pay Only
        5050 W TENNESSEE ST                                                                12. Plus Penalty                                          .
        TALLAHASSEE FL  32399-0120                                                         13. Plus Interest                                         .
                                                                                           14. Amount Due with Return                                .
        Due:
        Late After:                          9100 0 20239999 0001003031 1 4999999999 0000 5

  Certificate Number:                      Sales and Use Tax Return                        HD/PM Date:            /             /          DR-15 R. 01/20
        Florida               1. Gross Sales 2. Exempt Sales                               3. Taxable Amount                               4. Tax Due
A. Sales/Services/Electricity              .                       .                                                  .                              .
B. Taxable Purchases          Include use tax on Internet / out-of-state untaxed purchases                            .                              .
C. Commercial Rentals                      .                       .                                                  .                              .
D. Transient Rentals                       .                       .                                                  .                              .
E. Food & Beverage Vending                 .                       .                                                  .                              .
                                                                                           5. Total Amount of Tax Due
                              Surtax Rate:   Reporting Period                                                                                        .
                                                                                           6. Less Lawful Deductions                                 .
Name                                                                                       7. Net Tax Due                                            .
Address                                                                                    8. Less Est Tax Pd / DOR Cr Memo                          .
City/St                                                                                    9. Plus Est Tax Due Current Month                         .
   ZIP
                                                                                           10. Amount Due                                            .
        FLORIDA DEPARTMENT OF REVENUE                                                      11. Less Collection Allowance     E-file/E-pay Only
        5050 W TENNESSEE ST                                                                12. Plus Penalty                                          .
        TALLAHASSEE FL  32399-0120                                                         13. Plus Interest                                         .
                                                                                           14. Amount Due with Return                                .
        Due:
        Late After:                          9100 0 20239999 0001003031 1 4999999999 0000 5



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                                                                                                                                                                                                                   DR-15
                                                                                                                                                                                                                   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 a Florida 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.

                          Under penalties of perjury, I declare that I have read this return and the facts stated in it are true.
                                                                                                                                                                                        
             Signature of Taxpayer                            Date                Signature of Preparer                                                                                 Date
 ( ___________ ) ______________________________________                   ( ___________ ) _______________________________________
             Telephone Number                                                     Telephone Number

   Discretionary Sales Surtax - Lines 15(a) through 15(d)
15(a).  Exempt Amount of Items Over $5,000 (included in Column 3)  ...................................................................................15(a).   __________________________
15(b).  Other Taxable Amounts NOT Subject to Surtax (included in Column 3) ......................................................................15(b).   __________________________
15(c).  Amounts Subject to Surtax at a Rate Different Than Your County Surtax Rate (included in Column 3) ......................15(c).   __________________________
15(d). Total Amount of Discretionary Sales Surtax Due (included in Column 4) ...............................................................15(d).   __________________________
16.    Hope Scholarship Credits (included in Line 6) .............................................................................................................. 16.   __________________________
17.    Taxable Sales/Untaxed Purchases or Uses of Electricity (included in Line A) ............................................................... 17.   __________________________
18.    Taxable Sales/Untaxed Purchases of Dyed Diesel Fuel (included in Line A) ................................................................. 18.   __________________________
19.    Taxable Sales from Amusement Machines (included in Line A)  ................................................................................... 19.   __________________________
20.    Rural or Urban High Crime Area Job Tax Credits ............................................................................................................ 20.   __________________________
21.    Other Authorized Credits .................................................................................................................................................. 21.   __________________________

                          Under penalties of perjury, I declare that I have read this return and the facts stated in it are true.
                                                                                                                                                                                        
             Signature of Taxpayer                            Date                Signature of Preparer                                                                                 Date
 ( ___________ ) ______________________________________                   ( ___________ ) _______________________________________
             Telephone Number                                                     Telephone Number

   Discretionary Sales Surtax - Lines 15(a) through 15(d)
15(a).  Exempt Amount of Items Over $5,000 (included in Column 3)  ...................................................................................15(a).   __________________________
15(b).  Other Taxable Amounts NOT Subject to Surtax (included in Column 3) ......................................................................15(b).   __________________________
15(c).  Amounts Subject to Surtax at a Rate Different Than Your County Surtax Rate (included in Column 3) ......................15(c).   __________________________
15(d). Total Amount of Discretionary Sales Surtax Due (included in Column 4) ...............................................................15(d).   __________________________
16.    Hope Scholarship Credits (included in Line 6) .............................................................................................................. 16.   __________________________
17.    Taxable Sales/Untaxed Purchases or Uses of Electricity (included in Line A) ............................................................... 17.   __________________________
18.    Taxable Sales/Untaxed Purchases of Dyed Diesel Fuel (included in Line A) ................................................................. 18.   __________________________
19.    Taxable Sales from Amusement Machines (included in Line A)  ................................................................................... 19.   __________________________
20.    Rural or Urban High Crime Area Job Tax Credits ............................................................................................................ 20.   __________________________
21.    Other Authorized Credits .................................................................................................................................................. 21.   __________________________






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