Form Dr-228 - Documentary Stamp Tax Return For Nonregistered Taxpayers' Unrecorded Documents

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DR-228
Documentary Stamp Tax Return For
R. 08/11
Nonregistered Taxpayers’ Unrecorded Documents
Rule 12B-4.003
Florida Administrative Code
This return is for nonregistered taxpayers only and is due no later than the 20th
Effective 04/12
of the month following the execution month.
SEE INSTRUCTIONS ON REVERSE
SIDE.
o DO NOT attach original or copies of deeds or other documents to this return.
o Keep a copy of this return and a copy of your check for your records. Canceled check serves as your receipt of payment.
o Use Worksheet on reverse side to complete lines 4 – 8 on the tax return coupon below.
o DO NOT submit a photocopy of a DR-228 tax return.
o All documents listed must be executed and/or issued in the same month. A separate form must be completed for each month in which
a document was executed and/or issued.
o Taxpayers with five or more taxable transactions per month must register with the Department.
o Complete all information requested on the coupon.
o Mail coupon to:
Florida Department of Revenue
5050 W Tennessee St
Tallahassee FL 32399-0150
o SIGN AND DATE THE RETURN.
Florida Department of Revenue
DR-228
Documentary Stamp Tax Return For
R. 08/11
Nonregistered Taxpayers’ Unrecorded Documents
US Dollars
Cents
,
4. Miami-Dade County Surtax Due
Taxpayer Name ________________________________________________________________________
(from Step 5 of the worksheet)
,
5. Documentary Stamp Tax Due
Street Address ________________________________________________________________________
(from Step 6 of the worksheet)
,
City/State/ZIP ________________________________________________________________________
6. Penalty
(see instructions)
,
County ____________________________________________
7. Interest
(see instructions)
Under penalties of perjury, I declare that I have examined this tax
,
return and the facts stated in it are true.
8. Total Amount Due with Return
(sum of Lines 4 through 7)
_________________________________________________________________ ________________
-
Signature of Taxpayer
Date
FEIN
-
-
_____________________________________________ (_______) ____________________________
Title
Phone Number (include area code)
SSN (if no FEIN)
Do Not Write in the Space Below
9100 0 20141225 0019025036 5 4000001189 2797 4
***DETACH COUPON***
Florida Department of Revenue
DR-228
Documentary Stamp Tax Return For
R. 08/11
Nonregistered Taxpayers’ Unrecorded Documents
US Dollars
Cents
,
4. Miami-Dade County Surtax Due
Taxpayer Name ________________________________________________________________________
(from Step 5 of the worksheet)
,
5. Documentary Stamp Tax Due
Street Address ________________________________________________________________________
(from Step 6 of the worksheet)
,
City/State/ZIP ________________________________________________________________________
6. Penalty
(see instructions)
,
County ____________________________________________
7. Interest
(see instructions)
Under penalties of perjury, I declare that I have examined this tax
,
return and the facts stated in it are true.
8. Total Amount Due with Return
(sum of Lines 4 through 7)
_________________________________________________________________ ________________
-
Signature of Taxpayer
Date
FEIN
-
_____________________________________________ (_______) ____________________________
-
Title
Phone Number (include area code)
SSN (if no FEIN)
Do Not Write in the Space Below
9100 0 20141225 0019025036 5 4000001189 2797 4

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