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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 20249999 0001003031 8 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 20249999 0001003031 8 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

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