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                                                                                                                                                                         DR-16A
                    Application for Self-Accrual Authority / Direct Pay Permit                                                                                           R. 01/15
                                                                            Sales and Use Tax                                                                                       TC
                                                                                                                                                                         Rule 12A-1.097
                                                                                                                                                                  Florida Administrative Code
                                                                                                                                                                         Effective 01/15
            MAIL TO:
            ACCOUNT MANAGEMENT - MS 1-5730                                                                                      THIS AREA FOR DOR USE ONLY
            FLORIDA DEPARTMENT OF REVENUE                                                                                       PERMIT NO. ________________________________
            5050 W TENNESSEE ST                                                                                                 EFF DATE __________________________________
            TALLAHASSEE FL 32399-0160
                                                                                                                                EXP DATE __________________________________
PART I - Taxpayer Information
 Business Name                                                                                                              Sales Tax Certificate Number *
                                                                                                                            -                                     -
 Street Address                                                                                                             Federal Employer Identification Number (FEIN)
                                                                                                                            -
 City                                                                  State                                           ZIP  U.S. DOT Common Carrier Number **

 Name of Contact                                                                                                            Telephone Number - Including Area Code
                                                                                                                              - -
 Contact Mailing Address (if different than above)                          City                                                     State                                          ZIP

*   You must have a Florida sales tax certificate number before submitting this request.  If you have not registered for sales and use 
  tax and do not have a certificate number, you must complete and submit a Florida Business Tax Application (Form DR-1).  
PART II - Self-Accrual Category For Which You Are Applying (check only one):
Check the box next to the appropriate self-accrual authority type that describes your company’s qualifying circumstances.  See 
instructions for detailed descriptions of each category.

Apportionment (APP)
o  Air carriers engaged in interstate or foreign commerce.
o  Vessels engaged in interstate or foreign commerce.**
o  Railroads engaged in interstate or foreign commerce.**
o  Motor vehicles (common carriers) engaged in interstate or foreign commerce.**
** Common carriers must attach a copy of their letter of authority from the U.S. Department of Transportation (DOT).

Purchases of Tangible Personal Property (TPP)
o  Annual purchases of tangible personal property in excess of $10 million.
o  Annual purchases of tangible personal property in excess of $100,000 – taxability unknown at time of purchase. 

Promotional Materials (PRO)
o  Purchases of promotional materials – taxability unknown at time of purchase.

Real Property Leases (RPL)
o  Dealers required to remit sales tax electronically, who lease property from a number of independent property owners.
o  Dealers who lease real property from a number of independent property owners and, except for the lease or license 
  to the dealer, would not be required to register as dealers engaged in the business of leasing real property.
o  Operators of amusement or vending machines who lease real property from others.

PART III - Certification

I understand that a Sales and Use Tax Direct Pay Permit may only be used for the purposes indicated in section 212.183, Florida 
Statutes.  Under penalties of perjury, I declare that I have read the information provided in this Application and that the facts stated in 
it are true.

____________________________________________________    ____________________________________________________
Signature of Owner, Partner, Corporate Officer or Member                                                               Title

____________________________________________________    ____________________________________________________
Print Name                                                                                                             Date

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Information and Instructions for Completing DR-16A
R. 01/15
Application for Self-Accrual Authority / Direct Pay Permit Page 2
Sales and Use Tax

Section (s.) 212.183, Florida Statutes (F.S.), allows the Department to authorize certain sales tax dealers to pay directly to
the Department. Qualifying entities will be issued a direct pay permit to provide to their suppliers instead of paying sales
tax on authorized purchases or leases. Only one permit is required for all of your business locations.
> Complete Part I. • The purchase of tangible personal property by dealers who
> Complete Part II by reviewing the self-accrual authority annually purchase at least $100,000 of taxable tangible
categories and checking the category that qualifies your personal property, including maintenance and repairs for the
business for a direct pay permit. dealer’s own use, when the taxable status of such property
> Complete and sign Part III. Incomplete or unsigned will be known only upon its use. The taxable status of the
applications will be returned. property will be known upon its use when the dealer’s
> If you are a common carrier and are applying under the normal trade or business characteristics require the dealer to
apportionment category, you must attach a copy of your purchase tangible personal property that will either become
letter of authority from the U.S. Department of Transportation a component part of a product manufactured for sale or will
(DOT). be used and consumed by the dealer.
> Mail or deliver your completed application to:
ACCOUNT MANAGEMENT - MS 1-5730 Promotional Materials (PRO)
FLORIDA DEPARTMENT OF REVENUE • The purchase of promotional materials, as defined in
5050 W TENNESSEE ST s. 212.06(11)(b), F.S., by dealers who are unable to determine
TALLAHASSEE FL 32399-0160 at the time of purchase whether the promotional materials
will be used in Florida or exported from Florida only when
Self-Accrual Categories – Sales and Use Tax the seller of promoted subscriptions to publications sold in
Florida is a registered dealer and is remitting sales tax to
Apportionment (APP) the Department on publications sold in Florida. The dealer
• The apportionment of tax by eligible air carriers for the purchasing and distributing promotional materials and the
purchase or use of tangible personal property, as provided in seller of the promoted subscriptions to publications are not
s. 212.0598, F.S. required to be the same person.
• The partial exemption applicable to vessels and parts thereof
used in interstate or foreign commerce for the purchase of Real Property Leases (RPL)
vessels and parts thereof, as provided in s. 212.08(8), F.S., • The lease or license to use real property subject to tax under
and Rule 12A-1.064, Florida Administrative Code (F.A.C.). s. 212.031, F.S., by dealers who are required to remit sales
• The partial exemption applicable to railroads and parts tax electronically, as provided under s. 213.755, F.S., from a
thereof used in interstate or foreign commerce by licensed number of independent owners or lessors of real property.
railroad carriers for purchases of tangible personal property, • The lease or license to use real property subject to the tax
as provided in s. 212.08(9)(a), F.S., and Rule 12A-1.064, imposed under s. 212.031, F.S., by a dealer who leases
F.A.C. or obtains licenses to use real property from a number of
• The partial exemption applicable to motor vehicles and parts independent property owners who, except for the lease or
thereof used in interstate or foreign commerce by licensed license to the dealer, would not be required to register as
common carriers, as provided in s. 212.08(9)(b), F.S., and dealers engaged in the business of leasing real property.
Rule 12A-1.064, F.A.C. • The lease or license to use real property subject to the tax
imposed under s. 212.031, F.S., by operators of amusement
Purchases of Tangible Personal Property (TPP) machines or vending machines who lease or obtain licenses
• The purchase of tangible personal property by dealers to use real property from property owners or lessors for the
who annually purchase in excess of $10 million of taxable purpose of placing and operating an amusement or vending
tangible personal property in any county for the dealer’s own machine.
use.
Contact Us

If you need more information or have questions, call Information, forms, and tutorials are available on our website:
Taxpayer Services at 850-488-6800, Monday through floridarevenue.com
Friday (excluding holidays).
Subscribe to our tax publications to receive due date
For written replies to tax questions, write to: reminders or an email when we post:
TAXPAYER SERVICES - MS 3-2000 • Tax Information Publications (TIPs).
FLORIDA DEPARTMENT OF REVENUE • Proposed rules, notices of rule development
5050 W TENNESSEE ST workshops, and more.
TALLAHASSEE FL 32399-0112
Go to: floridarevenue.com/dor/subscribe
To find a taxpayer service center near you, go to:
floridarevenue.com/taxes/servicecenters

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