Form Dr-42b - Ownership Declaration And Sales And Use Tax - Report Of Vessel Purchase

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DR-42B
Ownership Declaration and Sales and Use Tax
R. 10/10
Report of Vessel Purchase
Rule 12A-1.097
Florida Administrative Code
Name of vessel
Year
Make
Model
USCG documentation or state reg. no.
Name of purchaser
Florida sales tax registration number
Daytime telephone number (include area code)
Address
City
State
ZIP
The vessel described above was purchased from (Name of seller, dealer, or broker)
Address
City
State
ZIP
Delivery was accepted at_________________________________________________on the________ day of __________________ 20________.
Name of marina, boat yard, etc.
Address
City
State
ZIP
Present location of vessel
Address
City
State
ZIP
Indicate the total purchase price, including any unpaid balance due seller, bank, or finance company. Include the total
consideration valued in money, whether paid in money or otherwise.
Total purchase price ..........................................................................
$ _______________________________________________________
Less: Trade-in (if applicable) ..................................................
$ _______________________________________________________
Net purchase price ............................................................................
$ _______________________________________________________
Florida tax due (6%) ..........................................................................
$ _______________________________________________________
Florida discretionary sales surtax .....................................................
$ _______________________________________________________
Less: Florida tax paid (attach copy of receipt) ......................
$ _______________________________________________________
Less: Taxes lawfully imposed and paid to another state .......
$ _______________________________________________________
(attach copy of receipt)
Balance due .....................................................................................
$ _______________________________________________________
Penalty (10% per month, up to 50%) ................................................
$ _______________________________________________________
Interest ..............................................................................................
$ _______________________________________________________
TOTAL DUE
$ _______________________________________________________
Under penalties of perjury, I declare that I have read the foregoing declaration and the facts stated in it are true.
_________________________________________________
_________________________________________________
Signature of Purchaser
Date
You must attach a copy of the Bill of Sale and
RETURN TO:
other documentation which evidences ownership
Department of Revenue
and actual selling price.
Compliance Campaigns
PO Box 6417
Tallahassee, FL 32314-6417

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