Florida Department of Revenue                                                DR-26S 
                                                                                                                  R. 07/23 
                                                                                                   Rule 12-26.008, F.A.C. 
                           Application for Refund - Sales and Use Tax                                     Effective XX/XX 
                                                                                                                  Page 1 of 2 
                                                                                                                  Provisional

Section 1: Taxpayer Information
Taxpayer Name:                                                        Sales Tax Certificate Number:

                                      Federal Employer Identification Number 
Business Partner Number:                                                     Social Security Number (SSN) *:
                                      (FEIN):

Mailing Street Address:

Mailing City:                         State:                                 ZIP:

Location Street Address:

Location City:                        State:                                 ZIP:

Telephone Number (include area code): Fax Number (include area code):        Email Address (optional):

Section 2: Taxpayer Representative - This section is to be completed when a taxpayer representative is requesting the 
refund. A signed Florida Department of Revenue Power of Attorney and Declaration of Representative (Form DR-835) must be 
attached.
Representative Name:

Street or Mailing Address:

City:                                 State:                                 ZIP:

Telephone Number:                     Fax Number:                            Email Address (optional):

Section 3: Collection or Reporting Period(s) - Enter the date the tax was paid and the collection or reporting period(s).
Date Paid (MM / DD / YY):                    Collection or Reporting Dates (MM / DD / YY to MM / DD / YY):

Section 4: Tax Categories - Check the box next to the type of tax you paid. 
A separate application must be completed for each fee or tax type.
 Amusement Machine         Solid Waste Fees
 Certificate Fee            Battery Fees                               Transient Rental Tax Paid to the Department
                            New Tire Fees                              Other (Please specify):
 Discretionary Sales Surtax
                            Rental Car Surcharge
 Sales and Use Tax          Gross Receipts Tax on Dry Cleaning

                                                                                                                                                         DR-26S 
                                                                                                                                                         R. 07/23 
                                                                                                                                                     Page 2 of 2
 Check the box next to the reason for your refund claim.
     Amended Replacement Return           Credit Memos                    FL Rural Areas of                                       Real Property Lease
     Audit Overpayment                                                    Opportunity
                                          Duplicate Payment                                                                       Repossessed Merchandise
     Bad Debt                                                             New/Expanding Business 
     Building Materials Used in           Estimated Tax                   Equipment                                               Transient Rental
     Construction of Eligible Residential                                 Motor Vehicles/Boat/ 
     Units for Affordable Housing         Exempt Sales                    Mobile Homes/Aircraft                                   Other (Please specify):
     Community Contribution               Florida Neighborhood            Motor Vehicle 
     Tax Credit                           Revitalization                  Repurchase/Replacement

 Section 5:  Refund Amount - Enter the refund amount.  Provide a brief explanation for the refund claim.
 Refund Amount:                           Brief Explanation for Refund:

   *Social security numbers (SSNs) are used by the Florida Department of Revenue as unique identifiers for the administration of Florida's taxes. SSNs 
   obtained for tax administration purposes are confidential under sections 213.053 and 119.071, Florida Statutes, and not subject to disclosure as public 
   records. Collection of your SSN is authorized under state and federal law. Visit the Department's website at floridarevenue.com/privacy for more 
   information regarding the state and federal law governing the collection, use, or release of SSNs, including authorized exceptions.
   Authorization and Signature 
   Under penalties of perjury, I declare that I have read the foregoing application and the facts stated in it are true.

Taxpayer Signature                                                                                       Date
 OR

 Representative Signature                                                                                Date

      Mail this application and applicable documentation to:  
     
      Refunds                                                                      For more information about the documentation 
      Florida Department of Revenue                              OR                                      needed to process your refund, or to check on the 
      PO Box 6490                                               Fax 850-410-2526                         application status, call Refunds at 850-617-8585.
      Tallahassee FL 32314-6490  
    
                                                                     Contact Us  

 Information and tutorials are available at floridarevenue.com/taxes/education. 
   
 Tax forms and brochures are available at floridarevenue.com/forms.  
   
 To speak with a Department of Revenue representative, call Taxpayer Services at 850-488-6800, Monday through Friday, 
 excluding holidays. 
   
 Subscribe to Receive Email Alerts from the Department. 
 Subscribe to receive an email for filing due date reminders, Tax Information Publications (TIPs), or proposed rules. Subscribe 
 today at floridarevenue.com/dor/subscribe.                                        
  
                                                                     Reference 
          The following document was mentioned in this form and is incorporated by reference in the rule indicated below. 
                                          The form is available online at floridarevenue.com/forms. 
                Form DR-835       Florida Department of Revenue Power of Attorney                                Rule 12-6.0015, F.A.C. 
                                       and Declaration of Representative