International Fuel Tax Agreement Florida Application-IFTA

In order for an owner or the assigned officer for a business entity wanting to demonstrate compliance with the fuel tax agreement in the State of Florida, the following form has to be completed and submitted.

Extracted Text for Proper Search

Bulk Fuel Storage Information 	
 	
Do you maintain bulk fuel storage for highway use? 	   � 	Yes   	�	  No 
If yes, indicate the fuel type and the jurisdiction where the bulk fuel is stored: 
 
Fuel Type:  ________________          Jurisdiction:  ________________________  
Fuel Type:  ________________          Jurisdiction:  ________________________  
Fuel Type:  ________________          Jurisdiction:  ________________________  
 	
1.  BUSINESS NAME – Print the name of the motor carrier making application.  If the name is other than a given name, attach a copy of the 
corporation papers or fictitious trade name papers filed with the Secretary of State. 	
 	
2.  FEDERAL EMPLOYER”S IDENTIFICATION NUMBER – Print the FEI # of the company.  If the company does not have a FEI #, a substitute 
number will be assigned.  This number should always be referenced when inquiring on your account. 	
 	
3.  BUSINESS LOCATION ADDRESS – Enter the actual location (address, city & zip) of your motor carrier business or office.  This address 
cannot be the address of a service provider or permitting company.  Post office boxes are not acceptable. 	
 	
4.  BUSINESS MAILING ADDRESS – Enter the address, city, state & zip where IFTA credentials are to be mailed. 	 	
5.  BUSINESS TELEPHONE NUMBER – Enter contact person’s business telephone number, including area code. 	 	
5a.  BUSINESS E-MAIL ADDRESS – Enter the business e-mail address.  
6.  CONTACT PERSON – Enter name of person to contact in reference to the account. 	 	
6a.  CONTACT PERSON’S E-MAIL ADDRESS – Enter the contact person’s e-mail address.  
7.  TYPE OF BUSINESS OWNERSHIP – Check the box that best describes your type of ownership. 	 	
8.  OWNER, PARTNERS OR CORPORATE OFFICERS NAME(S) – Print the name, home address, city, state & zip, SS# or FEI#, title, and 
telephone number of each. 	
 	
9.  U.S. DOT NUMBER – Enter your U.S. DOT number, if applicable. 	 	
10.  FL DRIVER LICENSE NUMBER – Enter your FLORIDA driver license number. 	 	
11.  FLORIDA INTERNATIONAL REGISTRATION PLAN ACCOUNT NUMBER – Enter your Florida IRP account number.  If you do not have a 
Florida IRP account, you must list the vehicle identification number for each vehicle in your fleet.  If extra space is needed, attach additional 
pages. 	
 	
12.  VEHICLE INFORMATION - Provide the name and state that vehicles are registered in, as well as the number of vehicles operating under this 
license application.  If you do not have a Florida IRP account, you will need to provide the vehicle identification number(s) for your qualified 
motor vehicle(s) registered in Florida.  If extra space is needed, attach additional pages. 	
 	
13.  Place a check mark in the YES or NO box to indicate whether or not you intend to consolidate ALL of your vehicles in Florida. 	 	
14.  Place a check mark in the YES or NO box to indicate whether or not you have ever held an IFTA license in another jurisdiction.  If YES, 
indicate which jurisdiction(s) license(s) was/were held. 	
 	
15.  Place a check mark in the YES or NO box to indicate whether or not your IFTA license has ever been revoked.  Place a check mark in the 
YES or NO box if your license is still revoked. 	
 	
16.  If a permitting service completes your IFTA tax return you must provide their name, address (city, state & zip code), and a telephone number 
including area code. 	
 	
To close the IFTA Account – you must first complete and file any outstanding tax return(s) and submit any tax due the State of Florida.  Your IFTA 
credentials must also be returned or a notarized letter stating they have been destroyed will need to be submitted.  Upon receipt of the requested 
information, your account will be closed. 
 
This application must be singed (by the owner, partner, corporate officer, or a person authorized by attached Power of Attorney), dated and a 
telephone number provided. 
 
Page 3 of this application is an order form for IFTA decals	
 – Provide the information requested on the top portion of the form.  On the bottom portion, 
indicate the decal year requested, date, and the number of IFTA decal sets needed.  Multiply by $4.00 and enter the total amount on the appropriate 
block in the form.  Mail payment and form to the specified address. 	
 
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