Florida Sales Tax Credit Scholarship Program
DR-117100
N. 07/18
Application to Change a Credit Allocation
Rule 12AER18-06, F.A.C.
Effective 07/18
Page 1 of 4
Section 1: Previously Received Credit Allocation Information
Tenant or Tenant Business Name:
Federal Employer Identification Number (FEIN or EIN)
(if available):
Allocation Application Number:
Original Approved Credit Allocation:
$
Contributions Paid:
Amount of Tax Credits Taken:
Credit Allocation Amount to Change:
$
$
$
Original Approved Credit Allocation – The amount of Florida Sales Tax Credit Scholarship Program (Program) funds allocated by the
Florida Department of Revenue to a tenant of commercial rental property for monetary contributions to be made to an eligible nonprofit
scholarship-funding organization during a state fiscal year to receive a tax credit against the state sales tax due on rent or license fees
for the property.
Contributions Paid – The amount of monetary contributions paid to an eligible nonprofit scholarship-funding organization participating
in the Program for which the tenant has received a certificate of contribution from the organization.
Amount of Tax Credits Taken – The amount of tax credit taken against the state sales tax due on rent or license fees for commercial
rental property due to your landlord. A credit allocation becomes a tax credit when a contribution has been paid to a nonprofit
scholarship-funding organization, the organization has issued a certificate of contribution to the contributing tenant, and the tenant has
deducted the amount of state tax due on the rent or license fees by the amount of the contribution paid.
Credit Allocation Amount to Change – The amount of unused credit allocation to be moved to a new landlord, a new commercial
rental property leased or rented by the tenant, or a new commercial rental property location leased or rented by a new landlord.
Section 2: Tenant Information
Business Mailing Address:
City:
State:
ZIP:
Contact Person Name:
Title:
Email Address*:
Telephone Number (include area code):
*Your privacy is important to the Florida Department of Revenue. Email addresses provided to the Department for tax administration
purposes are confidential and exempt from disclosure under section 213.053(2), Florida Statutes.
Florida law requires you to authorize the Florida Department of Revenue to respond to you using unencrypted email that does not
require additional steps before you can access information in the email. To expedite the processing of your application, you may wish
to receive unencrypted email regarding this application. If so, indicate your approval to receive unencrypted email by selecting 'Yes'
below, otherwise, select 'No.'
Yes. I authorize the Florida Department of Revenue to send information regarding this application using unencrypted email.
No. I wish to receive encrypted emails from the Florida Department of Revenue. (The software used to encrypt email
requires a one-time passcode or a user account.)
Section 3: Reason for Change in an Approved Credit Allocation.
Identify the change or changes that apply to you as a tenant holding a previously approved allocation of sales tax credits available
under the Florida Sales Tax Credit Scholarship Program.
I have moved to a different commercial rental property and I plan to use my previously approved credit allocation at the new
property location. (Your new commercial rental property location must be identified in Section 4.)
The landlord collecting and remitting sales tax on commercial rental property for which I received a credit allocation has
changed. (Your landlord must be identified in Section 5.)
Florida Sales Tax Credit Scholarship Program
DR-117100
N. 07/18
Application to Change a Credit Allocation
Rule 12AER18-06, F.A.C.
Effective 07/18
Page 1 of 4
Section 1: Previously Received Credit Allocation Information
Tenant or Tenant Business Name:
Federal Employer Identification Number (FEIN or EIN)
(if available):
Allocation Application Number:
Original Approved Credit Allocation:
$
Contributions Paid:
Amount of Tax Credits Taken:
Credit Allocation Amount to Change:
$
$
$
Original Approved Credit Allocation – The amount of Florida Sales Tax Credit Scholarship Program (Program) funds allocated by the
Florida Department of Revenue to a tenant of commercial rental property for monetary contributions to be made to an eligible nonprofit
scholarship-funding organization during a state fiscal year to receive a tax credit against the state sales tax due on rent or license fees
for the property.
Contributions Paid – The amount of monetary contributions paid to an eligible nonprofit scholarship-funding organization participating
in the Program for which the tenant has received a certificate of contribution from the organization.
Amount of Tax Credits Taken – The amount of tax credit taken against the state sales tax due on rent or license fees for commercial
rental property due to your landlord. A credit allocation becomes a tax credit when a contribution has been paid to a nonprofit
scholarship-funding organization, the organization has issued a certificate of contribution to the contributing tenant, and the tenant has
deducted the amount of state tax due on the rent or license fees by the amount of the contribution paid.
Credit Allocation Amount to Change – The amount of unused credit allocation to be moved to a new landlord, a new commercial
rental property leased or rented by the tenant, or a new commercial rental property location leased or rented by a new landlord.
Section 2: Tenant Information
Business Mailing Address:
City:
State:
ZIP:
Contact Person Name:
Title:
Email Address*:
Telephone Number (include area code):
*Your privacy is important to the Florida Department of Revenue. Email addresses provided to the Department for tax administration
purposes are confidential and exempt from disclosure under section 213.053(2), Florida Statutes.
Florida law requires you to authorize the Florida Department of Revenue to respond to you using unencrypted email that does not
require additional steps before you can access information in the email. To expedite the processing of your application, you may wish
to receive unencrypted email regarding this application. If so, indicate your approval to receive unencrypted email by selecting 'Yes'
below, otherwise, select 'No.'
Yes. I authorize the Florida Department of Revenue to send information regarding this application using unencrypted email.
No. I wish to receive encrypted emails from the Florida Department of Revenue. (The software used to encrypt email
requires a one-time passcode or a user account.)
Section 3: Reason for Change in an Approved Credit Allocation.
Identify the change or changes that apply to you as a tenant holding a previously approved allocation of sales tax credits available
under the Florida Sales Tax Credit Scholarship Program.
I have moved to a different commercial rental property and I plan to use my previously approved credit allocation at the new
property location. (Your new commercial rental property location must be identified in Section 4.)
The landlord collecting and remitting sales tax on commercial rental property for which I received a credit allocation has
changed. (Your landlord must be identified in Section 5.)
DR-117100
N. 07/18
Page 2 of 4
Section 4: NEW Commercial Rental Property Location Information
Physical Street Address of New Commercial Rental Property:
City:
State:
ZIP:
Florida
Section 5: New Landlord Information
New Landlord Business Name:
New FEIN or EIN:
New Landlord Sales Tax Certificate Number of Rental Property (only when the Landlord is not required to obtain a FEIN or EIN):
New Business Mailing Address:
City:
State:
ZIP:
New Contact Person Name:
New Telephone Number (include area code):
Section 6: Authorization for Direct Communication with Your New Landlord
To complete the processing of your application, additional information about the tax account established with the Florida Department of
Revenue by your new landlord for the property listed may be required. If you wish to allow the Department to contact your new landlord
directly about the tax you pay to the landlord, a written consent from you is required.
I authorize the Florida Department of Revenue to contact the new Landlord regarding the sales tax credit available under the
Florida Sales Tax Credit Scholarship Program for the identified property.
I do not authorize the Florida Department of Revenue to contact the new Landlord regarding the sales tax credit available
under the Florida Sales Tax Credit Scholarship Program for the identified property.
Section 7: Notification and Signature
I understand that section 212.099, Florida Statutes, requires the Florida Department of Revenue to provide a copy of any approval or
denial letter issued with respect to this application to the selected nonprofit scholarship-funding organization.
Under penalties of perjury, I declare that I have read this application and the facts stated in it are true.
____________________________________________________
____________________________________
Signature of Tenant – Owner, Officer, or Partner
Date
Mail this application to:
Florida Department of Revenue
Revenue Accounting
or
Fax 850-410-2526
PO Box 6490
Tallahassee FL 32314-6490
Contact Information
For additional information regarding the Florida Sales Tax Credit Scholarship Program, contact:
Revenue Accounting
Phone: 850-617-8586
Fax: 850-410-2526
Email: RevenueAccounting@floridarevenue.com
Instructions
DR-117100
N. 07/18
Page 3 of 4
Florida Sales Tax Credit Scholarship Program
The Department will review your application to
determine whether you remain eligible for the credit
The Florida Sales Tax Credit Scholarship Program
allocation. If approved, a letter will be issued to you
(Program) authorizes the tenant of a commercial rental
indicating the amount of credit allocation approved
property to receive a tax credit against the state tax due
for the new landlord or for the new commercial rental
on the rent or license fees for contributions paid to an
property, or both the new landlord and the new
eligible nonprofit scholarship-funding organization.
commercial rental property location. If the Department
Tenants of commercial rental property must apply
is not able to approve the changes in the credit
to the Florida Department of Revenue (Department)
allocation you requested, a letter will be mailed to
using a Florida Sales Tax Credit Scholarship
you explaining why a credit allocation could not be
Program – Application for a Tax Credit Allocation
approved.
(Form DR-117000, incorporated by reference in Rule
Tenant Contribution to an Eligible Nonprofit
12AER18-06, F.A.C.) to receive an allocation of the
Scholarship-Funding Organization
funds available for sales tax credits each state fiscal
year (July 1 – June 30).
If the change in your credit allocation is approved,
you must make a monetary contribution to the
Changes to a Credit Allocation
organization you selected in your original application.
I
f you are a tenant participating in the Program and
The contribution must be made before you are entitled
you have received a credit allocation, you must notify
to a tax credit under the Program. The contribution
the Department prior to claiming the tax credit when:
must be made within the same state fiscal year (July 1
– June 30) the credit allocation was issued. When you
• your landlord collecting and remitting sales tax on
make your contribution, the organization receiving the
the commercial rental property changes; or
contribution will issue a certificate of contribution.
• you move to another commercial rental property
Receiving the Allocated Tax Credit
and plan to use your credit allocation to receive
a tax credit at your new commercial rental property
When taking a tax credit against the state tax due on
location.
the rent or license fees for commercial rental property,
provide your landlord:
Lease Payment Schedule Required
• a copy of the updated credit allocation approval
If you contributed to an eligible nonprofit scholarship-
letter issued by the Department; and
funding organization to receive a tax credit under
the Program, attach a schedule (sample included)
• a copy of the certificate of contribution issued by an
containing the following information regarding the rent
eligible nonprofit scholarship-funding organization.
or license fee paid on the commercial rental property
Retain the original credit allocation approval letter,
for which your original credit allocation was beginning
the updated credit allocation approval letter, and the
with the date your credit allocation was approved by
certificate of contribution in your records.
the Department:
Contact Information
• the amount of each rent or license fee payment;
For additional information regarding the Florida Sales
• the date of each rent or license fee payment;
Tax Credit Scholarship Program, contact:
• the sales tax and discretionary sales surtax due on
Revenue Accounting
each payment; and
Phone: 850-617-8586
Fax: 850-410-2526
• the amount of the tax credit claimed for each rent
Email: RevenueAccounting@floridarevenue.com
or license fee payment.
DR-117100
Lease Payment Schedule
N. 07/18
Page 4 of 4
Tenant or Tenant Business Name:
FEIN or EIN (if available):
Street Address:
Rental Property Address:
City, State, ZIP Code:
Landlord Name:
Landlord FEIN or EIN (if available):
State Sales Tax
Rent or License
Total Sales Tax
Credit Taken
Date Paid
Total Surtax Due
Fee Payment
Due
(Amount Deducted from
Payment)