COMPANY, incorporated in the state of STATE, its undersigned officer who is duly authorized, hereby certifies to QUALIFYING NEW OR EXPANDING BUSINESS, OR CONTRACTOR, OR SUBCONTRACTOR it has paid sales tax to the Department of Revenue, State of Florida, totaling the sum of $_________. Said taxes were collected by COMPANY upon the sales of tangible personal property as evidenced by the attached invoice(s).
The company further certifies the sales tax for the attached invoice(s) was paid to the State of Florida in the month following the date of sale under sales tax number _________.
Dated at ________ County _______, Florida, this ___ day of ___ 20___.
AUTHORIZED OFFICER OF COMPANY
BY: _______________________________
TITLE: ____________________________
Fla. Admin. Code Ann. R. 12A-1.096
Rulemaking Authority 212.08(5)(b)4., 212.18(2), 213.06(1) FS. Law Implemented 212.02(4), (10)(g), (14), (19), (21), (22), 212.05, 212.06, 212.08(5)(b), (7)(xx), 212.13(2), 213.255(2), (3), 215.26(2) FS.
New 5-11-92, Amended 7-1-99, 6-28-00, 6-19-01, 3-6-02, 4-1-08, 1-12-11, 1-17-13.