REGISTRATION FORM Tourist Development Tax Section Records

Board of County Commissioners, Broward County, Florida
Finance and Administrative Services Department
Records, Taxes and Treasury Division - Tourist Development Tax Section
REGISTRATION FORM
1. RENTAL PROPERTY INFORMATION:
6. TYPE OF BUSINESS:
Name:
Address:
____Corporation
____Individual
____Partnership
____Limited Liability Co.
____Other:
City:
State:
Zip Code:
7. TYPE OF RENTAL:
Phone:
Is this property leased from another party?
Yes
2. OWNER INFORMATION:
No
____Apartment
____Boarding Room
____Campground
____Condominium
____Hotel/Motel
____Multi-Family Home
____RV / Mobile Home Park
____Time Share
____Real Estate/Property Manager
Name:
____Single Family Home
Address:
____Other:
City:
State:
Zip Code:
8. NUMBER OF:
Phone:
Total Units:
E-Mail Address:
Transient Units:
9. BANK INFORMATION:
3. DEALER / LESSEE INFORMATION:
Name:
Name:
Account No:
Address:
City:
State:
Zip Code:
Phone:
City:
State:
10. SELECT MAILING ADDRESS:
E-Mail Address:
1.
2.
3.
11. APPLICANT:
4. BEGINNING BUSINESS DATE:
5. FED. TAX ID NUMBER:
Name (print)
Title
Signature
Date
SALES TAX / CERT. NO.:
FDOR FILING FREQUENCY:
LOCAL BUS. TAX RCPT. NO.:
RETURN TO:
OFFICIAL USE ONLY:
COUNTY ACCOUNT NO:
401-210
FOLIO NO:
Tourist Development Tax Section
Records, Taxes and Treasury Division
115 S. Andrews Avenue, Room A-110
Fort Lauderdale, FL 33301
Office: 954-357-8455 Fax: 954-357-6524
touristax@broward.org
Board of County Commissioners, Broward County, Florida
Finance and Administrative Services Department
Records, Taxes and Treasury Division - Tourist Development Tax Section
REGISTRATION FORM
INSTRUCTIONS
1. RENTAL PROPERTY INFORMATION:
Enter trade, fictitious (d/b/a), or location (i.e. hotel, motel, apartment building, condominium complex) name. Enter the
actual physical (street) address of the rental property. A post office box is not an acceptable address. Indicate by placing
a check mark on the appropriate line if this property is rented from another party. Agents (such as representatives,
property managers or management companies) filing tax returns which report transient rental revenue from separately
owned properties under a single account must attach a schedule indicating the property owner and property address.
2. OWNER INFORMATION:
Enter the rental property owner’s name (i.e., individual, partner, corporate, etc.,) address, telephone number, and E-Mail
address.
3. DEALER / LESSEE INFORMATION:
If applicable, enter the dealer’s name (i.e., operator, property manager, etc.) or lessee’s name, address, telephone
number and E-Mail address. The dealer’s information relates to individuals or entities designated by the owner to be
responsible for the business aspects of the rental property. The lessee’s information relates to individuals or entities that
do not own the rental property but hold a lease from the property owner.
4. BEGINNING BUSINESS DATE:
Enter the date this business or individual became or will become liable for Broward County Tourist Development Tax.
5. Enter your Federal Tax ID number.
Enter your Florida Department of Revenue Sales Tax / Certificate Number.
Enter your Florida Department of Revenue Filing Frequency (i.e. Monthly, Quarterly, Semi-Annual or Annual).
Enter your Broward County Local Business Tax Receipt Number.
6. TYPE OF BUSINESS:
Place a check mark on the appropriate line. If “Other”, please state the type in the space provided.
7. TYPE OF RENTAL:
Place a check mark on the appropriate line. If “Other”, please state the type in the space provided.
8. NUMBER OF UNITS:
Indicate the number of total units and transient rental units located at the rental property address.
9. BANK INFORMATION:
Enter the name of the bank, account number, city and state where the business bank account is located.
10. SELECT MAILING ADDRESS:
Place a check mark on the line indicating the mailing address for tax returns and official correspondence.
One (1) is the Rental Address, Two (2) is the Owner Address and Three (3) is the Dealer or Lessee Address.
11. APPLICANT:
Enter the authorized person’s printed name and title.
All forms must contain the authorized person’s signature and date.
401-210