"Application for Brevard County Business Tax Receipt" - Brevard County, Florida

Application for Brevard County Business Tax Receipt is a legal document that was released by the Florida Department of Revenue - a government authority operating within Florida. The form may be used strictly within Brevard County.

Form Details:

  • Released on June 27, 2012;
  • The latest edition currently provided by the Florida Department of Revenue;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Florida Department of Revenue.

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Download "Application for Brevard County Business Tax Receipt" - Brevard County, Florida

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INSTRUCTIONS & INFORMATION FOR OWNERSHIP TRANSFER 
ATTENTION
  
Your application for Brevard County Business Tax Receipt cannot be processed until the requirements have been met and proof 
submitted with application. Original copies may be presented for verification when applying in person. Photocopies should be 
used when submitting by mail. 
Instructions:  
1. Submit copy of current Brevard County Business Tax Receipt and a copy of the Bill of Sale.  
2. Complete the Business Tax Receipt application. For questions concerning this form, contact the Tax Collector's Office at 
321‐264‐6910 or 321‐633‐2199 ext 46910.  
3. Provide a copy of your current City Tax Receipt reflecting the current business location and type of business that is being 
conducted at that location. Contact your City Clerk for information on the city receipt. If location is in the unincorporated 
area, provide a completed owner authorization form or proof of ownership for the business property.  
4. If using a business name, provide a copy of the fictitious name registration and/or Corporation receipt from Florida 
Secretary of State.  
5. Other documents may be required depending on the type/nature of business you are conducting i.e. State of Florida 
Certification, certificate of competency, Florida Dept of Agricultural and Consumer Service certification, auto dealer’s 
license, etc.  
6. If you are applying fertilizer to turf/or landscape plants in the course of a commercial business (ex. Landscaping, yard care, 
etc.), you are required to provide a copy of a DOACS Certification issued by The Bureau of Entomology and Pest Control at 
850‐617‐7997.  If fertilizer is being applied to turf/or landscape plants to a business property by an employee of the 
business (ex. cemeteries, power plants, hotel/motel, schools, etc.), you are required to provide a copy of a Certificate of 
Training Best Management Practices by Florida Green Industries at 352‐273‐4517. 
7. The applicable Business Tax transfer of ownership fee is $5.00. Please submit this amount along with your application and 
other required documents. If your current Business Tax Receipt has not yet been paid, please submit current amount due 
plus transfer of ownership fee.  
8. Proof of personal identification is required.  
 
   
 
 
Requirements  (a copy of one or more of these requirements may need to be submitted depending on the business name and the 
nature of the business):  
 Fictitious name registration and/or Corporation receipt from Florida Secretary of State. 850‐488‐9000 www.sunbiz.org  
 Certificate of Competency or State of Florida Certification [Contractors]. County: 321‐633‐2058 State: 850‐487‐1395  
 State of Florida Certificate or Registration as subject to: Dept of Business and Professional Regulation or other  
Regulatory Boards. i.e., Florida Bar, State Dept of Health, Secretary of State, etc.  
 Certificate(s) from Hotel & Restaurant Commission. 850‐487‐1395 (State of Florida Dept. of Business Regulation)  
  Florida Dept of Agriculture & Consumer Services 800‐435‐7352  
 Auto Dealer's License [FL Dept of Highway Safety & Motor Vehicles] 321‐383‐2748  
 Second Hand Dealer License 321‐757‐7070 [Dept. of Revenue] Notify Brevard County Sheriff Pawn Compliance: 321‐617‐7306  
 
 
Mail to:  Brevard County Tax Collector 
To Apply In Person:  Brevard County Tax Collector 
th
 
   P.O. Box 2500 
           400 South Street, 6
 Floor 
 
   Titusville, FL  32781‐2500 
           Titusville, FL  32780 
INSTRUCTIONS & INFORMATION FOR OWNERSHIP TRANSFER 
ATTENTION
  
Your application for Brevard County Business Tax Receipt cannot be processed until the requirements have been met and proof 
submitted with application. Original copies may be presented for verification when applying in person. Photocopies should be 
used when submitting by mail. 
Instructions:  
1. Submit copy of current Brevard County Business Tax Receipt and a copy of the Bill of Sale.  
2. Complete the Business Tax Receipt application. For questions concerning this form, contact the Tax Collector's Office at 
321‐264‐6910 or 321‐633‐2199 ext 46910.  
3. Provide a copy of your current City Tax Receipt reflecting the current business location and type of business that is being 
conducted at that location. Contact your City Clerk for information on the city receipt. If location is in the unincorporated 
area, provide a completed owner authorization form or proof of ownership for the business property.  
4. If using a business name, provide a copy of the fictitious name registration and/or Corporation receipt from Florida 
Secretary of State.  
5. Other documents may be required depending on the type/nature of business you are conducting i.e. State of Florida 
Certification, certificate of competency, Florida Dept of Agricultural and Consumer Service certification, auto dealer’s 
license, etc.  
6. If you are applying fertilizer to turf/or landscape plants in the course of a commercial business (ex. Landscaping, yard care, 
etc.), you are required to provide a copy of a DOACS Certification issued by The Bureau of Entomology and Pest Control at 
850‐617‐7997.  If fertilizer is being applied to turf/or landscape plants to a business property by an employee of the 
business (ex. cemeteries, power plants, hotel/motel, schools, etc.), you are required to provide a copy of a Certificate of 
Training Best Management Practices by Florida Green Industries at 352‐273‐4517. 
7. The applicable Business Tax transfer of ownership fee is $5.00. Please submit this amount along with your application and 
other required documents. If your current Business Tax Receipt has not yet been paid, please submit current amount due 
plus transfer of ownership fee.  
8. Proof of personal identification is required.  
 
   
 
 
Requirements  (a copy of one or more of these requirements may need to be submitted depending on the business name and the 
nature of the business):  
 Fictitious name registration and/or Corporation receipt from Florida Secretary of State. 850‐488‐9000 www.sunbiz.org  
 Certificate of Competency or State of Florida Certification [Contractors]. County: 321‐633‐2058 State: 850‐487‐1395  
 State of Florida Certificate or Registration as subject to: Dept of Business and Professional Regulation or other  
Regulatory Boards. i.e., Florida Bar, State Dept of Health, Secretary of State, etc.  
 Certificate(s) from Hotel & Restaurant Commission. 850‐487‐1395 (State of Florida Dept. of Business Regulation)  
  Florida Dept of Agriculture & Consumer Services 800‐435‐7352  
 Auto Dealer's License [FL Dept of Highway Safety & Motor Vehicles] 321‐383‐2748  
 Second Hand Dealer License 321‐757‐7070 [Dept. of Revenue] Notify Brevard County Sheriff Pawn Compliance: 321‐617‐7306  
 
 
Mail to:  Brevard County Tax Collector 
To Apply In Person:  Brevard County Tax Collector 
th
 
   P.O. Box 2500 
           400 South Street, 6
 Floor 
 
   Titusville, FL  32781‐2500 
           Titusville, FL  32780 
APPLICATION FOR BREVARD COUNTY BUSINESS TAX RECEIPT
COMPLETE THIS SECTION: (Print or Type)
Original Application
Transfer / Correction of Existing Tax Receipt
1. BUSINESS NAME:  
__________________________________________________________________________________ 
Individual Professionals: Skip Line #1
BUSINESS NAME = Trade Name D/B/A
2. OWNER(S):
  ______________________________________________________________________________________ 
3. TELEPHONE:
   Business:  ______________________________   
Cell:  ___________________________________ 
              Home:  ________________________________                  Fax:  ___________________________________ 
4. LOCATION:  
________________________________________________________________________________________ 
[Physical Street Address; NOT a P.O. Box ]
IS THE SUBJECT PROPERTY WITHIN CITY LIMITS?
IF YES, CITY RECEIPT # ___________________
YES
NO
IF NO, COMPLETE ZONING VERIFICATION SECTION ON BACK PAGE: (Brevard County Zoning Div. Ph # 321-633-2070)
MAILING ADDRESS:  __________________________________________________________________________________ 
5.
6. OPENING DATE OF BUSINESS, OR DATE BUSINESS ASSUMED OR RELOCATED: ___________________________
7. FLORIDA SALES TAX REGISTRATION # _______________________________________ (If Applicable)
8. FIN # _______ - _____________________________ OR SS# _______________________________________ *
9. CERTIFICATION OR STATE BOARD # ________________________________________________________________
(CONTRACTORS, PROFESSIONALS, ETC.)
10. NATURE OF BUSINESS:
_________________________________________________________________________________________
(SPECIFY ACTIVITY / ACTIVITIES, TYPE OF SALES OR SERVICE)
11. DO YOU APPLY FERTILIZER TO TURF AND/OR LANDSCAPE PLANTS?
YES
NO
(See Instructions & Information Sheet for more information.)
12. EMAIL:
  ______________________________________________  WEBSITE:  ______________________________________________________ 
ACKNOWLEDGMENT:
Issuance of a Brevard County Business Tax Receipt DOES NOT certify compliance with related Florida Laws or Brevard County
Ordinances. Although regulatory requirements for specified activities may have been required by Statute, failure to disclose specific activities
(on line 10) may result in insufficient determination of known pre-requisites. Although zoning verification may have accompanied this application,
specific violations are not defensible by issuance of this tax receipt.
Services, construction related activities, and other shall be responsible for determining the limitations of activities which otherwise require
regulatory compliance (i.e. "Handyman" prohibited from Electrical, Plumbing, Roofing, etc. which requires Certificate of Competency, or State of
Florida Certification). The Brevard County Business Tax Receipt shall be subject to revocation upon notification by appropriate Regulatory
Agency, or knowledge by Tax Collector (& employees) that activities are engaged in which require Regulatory compliance, until such Regulatory
requirement is fulfilled, or until prohibited activity ceases.
* Pursuant to Florida Statute 119.071(5)(a)2.a, the purpose for the Tax Collector’s collection of an individual’s social security number for
this application is to comply with Florida Statute 205.0535(5) which requires that no local business tax receipt be issued unless the social
security number is obtained from the person to be taxed.
I hereby declare the information submitted herein to be true to the best of my knowledge, and that I have read the above acknowledgment.
APPLICANT’S SIGNATURE X ____________________________________________________ DATE________________________
Identification (Driver Lic. # etc) _______________________________________________
Florida Driver’s License, notarized acknowledgment, Corporate Charter Receipt from Secretary of State. If application is completed by other than owner(s)
[including ALL partners], a copy of the organizational documents must be included. (i.e. partnership agreement, Corporate charter, etc.)
 
DO NOT WRITE IN THIS BLOCK: TAX COLLECTOR’S USE
Ownership
Location
 
 
 
 
 
 
 
  TRANSFER:
 
*SUBMIT COPY OF CURRENT RECEIPT
ACCOUNT #
______________________
RECEIPT AMOUNT
$0.00 (if paid)
 
EXEMPTION
______________________ City Code ________
TRANSFER OF
$5.00
 
CLASSIFICATIONS:
CERTIFICATION#
OWNERSHIP
________________________
____________________
________________________
____________________
 
________________________
____________________
TOTAL DUE:
$5.00
________________________
____________________
 
Mailed / Distributed by: __________ Date: ___________
WEBSITE
 
Advised of T.P.P. (Acct #): _____________ Issued By: ___________ Date: __________
OWNER AUTHORIZATION FORM
This form is not required if the applicant is the owner of the property for which the business tax receipt is being
applied. Complete section (1) or provide proof of authorization to use the subject property with any one of the
documents listed below under Section (2)
SECTION (1)
APPLICANT’S NAME: _____________________________________________________________________________
BUSINESS NAME: _________________________________________________________________________________
PROPERTY OWNERS NAME: _______________________________________________________________________
PROPERTY ADDRESS: _____________________________________________________________________________
PROPERTY DESCRIPTION:
_____TOWNSHIP _____RANGE ______SECTION ______SUBDIVISION ______PARCEL/BLOCK _____LOT
NATURE OF BUSINESS: ___________________________________________________________________________
I, __________________________________, as the owner/legal representative of the above described property, and
having the authority of same, do authorize the aforementioned Applicant and Business to utilize this property location to
operate said business.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT
AND THAT THE FACTS STATED IN IT ARE TRUE.
_____________________________________________
Owner/Legal Representative
ANY PERSON FALSIFYING DOCUMENTS OR PROVIDING FALSE INFORMATION FOR THE PURPOSE OF OBTAINING
ZONING APPROVAL FOR A BUSINESS TAX RECEIPT SHALL BE SUBJECT TO PROSECUTION AND A FINE NOT TO
EXCEED $500 OR IMPROISONMENT IN THE COUNTY JAIL FOR A PERIOD NOT TO EXCEED 60 DAYS, OR BOTH SUCH
.
FINE AND IMPRISONMENT
SECTION (2)
As an alternative to Section (1), provide any ONE of the following documents:
A) Notarized letter from the owner of record
B) Current copy of a lease agreement
C) Copy of a contract
D) Other pertinent data that authorizes use of the property
(updated
6/27/2012)
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