Form Dr-248 - Alternative Fuel Use Permit Application, Renewal, And Decal Order Form - 2013

ADVERTISEMENT

DR-248
DR-248
Alternative Fuel Use Permit
Alternative Fuel Use Permit
R. 11/12
R. 11/12
Application, Renewal, and Decal Order Form
Application, Renewal, and Decal Order Form
Rule 12B-5.150
Rule 12B-5.150
Florida Administrative Code
Florida Administrative Code
For Calendar Year _____
2013
Effective Date: 01/13
Effective Date: 01/13
Permit Number:
Permit Number:
For Period Ending:
For Period Ending:
FEIN or Social Security Number:
FEIN or Social Security Number:
Enter owner name, location address, and mailing address.
Enter owner name, location address, and mailing address.
Computation of Decal Fee(s)
Computation of Decal Fee(s)
Name of
Name of
Class A
Class A
Class B
Class B
Class C
Class C
Class A + B + C
Class A + B + C
county in
county in
which the
which the
vehicle is
vehicle is
Total
Total
Annual
Annual
= Class Total
= Class Total
= Class Total
= Class Total
= Class Total
= Class Total
x Number
x Number
x Number
x Number
x Number
x Number
Rate
Rate
Rate
Rate
Rate
Rate
predominately
predominately
Vehicles
Vehicles
Fees
Fees
of Vehicles
of Vehicles
of Vehicles
of Vehicles
of Vehicles
of Vehicles
used
used
271.50
271.50
271.50
380.10
380.10
380.10
199.10
199.10
199.10
199.10
199.10
199.10
271.50
271.50
271.50
380.10
380.10
380.10
199.10
199.10
199.10
271.50
271.50
271.50
380.10
380.10
380.10
199.10
199.10
199.10
271.50
271.50
271.50
380.10
380.10
380.10
199.10
199.10
199.10
271.50
271.50
271.50
380.10
380.10
380.10
271.50
271.50
271.50
380.10
380.10
380.10
199.10
199.10
199.10
199.10
199.10
199.10
271.50
271.50
271.50
380.10
380.10
380.10
199.10
199.10
199.10
271.50
271.50
271.50
380.10
380.10
380.10
Total
Total
+
+
=
=
+
+ +
Decals
Decals
Annual
Annual
$
$
$
$
$
$
+
+
=
=
+
+
Fees
Fees
x
x
Proration Factor
Proration Factor
(see Lines 9 and 10 of instructions)
(see Lines 9 and 10 of instructions)
$
$
Total Fees Due
Total Fees Due
Print or type applicant’s name _____________________________________________________
Print or type applicant’s name _____________________________________________________
Title ____________________________________Contact phone number ___________________________
Title ____________________________________Contact phone number ___________________________
Under penalty of perjury, I declare that I have read this application and the facts stated in it are true.
Under penalty of perjury, I declare that I have read this application and the facts stated in it are true.
Signature of applicant ____________________________________________________________________
Signature of applicant ____________________________________________________________________
Note: Social security numbers (SSNs) are used by the Florida Department of Revenue as unique identifiers for the administration of Florida’s taxes. SSNs
Note: 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.
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 our Internet site at and select “Privacy Notice” for more
Collection of your SSN is authorized under state and federal law. Visit our Internet site at and select “Privacy Notice” for more
information regarding the state and federal law governing the collection, use, or release of SSNs, including authorized exceptions.
information regarding the state and federal law governing the collection, use, or release of SSNs, including authorized exceptions.

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Dr-248 - Alternative Fuel Use Permit Application, Renewal, And Decal Order Form - 2010 Form Dr-248 - Alternative Fuel Use Permit Application, Renewal, And Decal Order Form - 2010 Financial
Form Dr-248 - Alternative Fuel Use Permit Application, Renewal, And Decal Order Form - 2009 Form Dr-248 - Alternative Fuel Use Permit Application, Renewal, And Decal Order Form - 2009 Financial
Form Dr-248 - Alternative Fuel Use Permit Application, Renewal, And Decal Order Form - 2011 Form Dr-248 - Alternative Fuel Use Permit Application, Renewal, And Decal Order Form - 2011 Financial
Form Dr-248 - Alternative Fuel Use Permit Application, Renewal, And Decal Order Form - 2008 Form Dr-248 - Alternative Fuel Use Permit Application, Renewal, And Decal Order Form - 2008 Financial
Form Dr-248 - Alternative Fuel Use Permit Application, Renewal, And Decal Order Form - 2012 Form Dr-248 - Alternative Fuel Use Permit Application, Renewal, And Decal Order Form - 2012 Financial
Form M-36 - Combined Claim Form For Refund Of Fuel Taxes Liquid Fuel (gasoline) Used For Agricultural Equipment Operated Off Public Highways, Diesel Oil Used For Motor Vehicle Operated Off Public Highways, And Alternative Fuel Used For Motor Vehicle And I Form M-36 - Combined Claim Form For Refund Of Fuel Taxes Liquid Fuel (gasoline) Used For Agricultural Equipment Operated Off Public Highways, Diesel Oil Used For Motor Vehicle Operated Off Public Highways, And Alternative Fuel Used For Motor Vehicle And I Financial
Form Mfut-12 - Motor Fuel Use Tax Ifta License And Decals Application - 2010 Form Mfut-12 - Motor Fuel Use Tax Ifta License And Decals Application - 2010 Financial
Form Mfut-12 - Application For Motor Fuel Use Tax Ifta License And Decals January 2005 Form Mfut-12 - Application For Motor Fuel Use Tax Ifta License And Decals January 2005 Financial
Form Mfut-12 - Application For Motor Fuel Use Tax Ifta License And Decals - 1999 Form Mfut-12 - Application For Motor Fuel Use Tax Ifta License And Decals - 1999 Financial
Form Ifta-21-v - Payment Voucher And Instructions For International Fuel Tax Agreement (ifta) Licenses And Decals Renewed Electronically Form Ifta-21-v - Payment Voucher And Instructions For International Fuel Tax Agreement (ifta) Licenses And Decals Renewed Electronically Life

Related Categories

Parent category: Financial
Download
Go
Page of 4