Office of Joe G. Tedder, Tax Collector for Polk County, Florida

PO Box 2016 | Bartow, FL 33831-2016 | Tel. 863-534-4700 | Fax: 863-534-4735 | Email: BT@PolkTaxes.com

COUNTY LOCAL BUSINESS TAX ACCOUNT APPLICATION FORM

To be submitted July through September

SECTION

Application Instructions: Please print. Enter all required information. Once completed, follow payment instructions at the bottom of page 2.

Note: Tangible Personal Property information and the telephone number and email address provided in this application are recorded on behalf of the Property Appraiser as part of the applicant’s

tangible personal property tax return (required under F.S. 193) and are not subject to a regular public records request. Applicants can have their telephone number and email address made

available to the public by checking the applicable box provided. Social Security (SSN) or Federal Employment Identification (FEIN) Number is required under F.S. 205.0535 (5). SSN and FEIN

3. Fictitious Name: A Fictitious Name or “Doing Business As” Name is used by a Corporation, General Partnership, Limited Partnership,

8. Tangible Personal Property: Florida Statute 193.052 requires that all Tangible Personal Property (TPP) be reported each year to the

The deadline to file the TPP Tax Return is April 1. If you do not file a return or extension by the deadline, you will not qualify for the

$25,000 Tangible Personal Property Exemption.

Review instructions and enter code number.

 If at least one item listed above is a “B” and no item is a “C”, the applicant is a Class “B” Business and the annual tax due is $72.19

Please review the following.

= State Regulated Class B Activity

= Declared Class C Activity

=

Applicant must also provide copy of state

Note: Numeric County Business Tax Code precedes listing.

AGRICULTURE

PROPERTY SALES, LEASING

PROFESSIONAL, TECHNICAL

LOOKING FOR OTHER ACTIVITIES?

To obtain an exemption, please complete section 10 of the

application. If documentation is required to be submitted for

the specific exemption, please attach the required

documentation with your written request.

* Consult Chapter 205 of the Florida Statutes and Polk County

property tax exemption; disabled person hunting license; disabled person

fishing license; and/or certification from a reputable physician stating that

the applicant is disabled.*

providing personal identification, proof of a deceased spouse, and at least

one minor dependent (child under the age of eighteen). *

can demonstrate they are the unremarried spouse of a deceased disabled

exemption is available to the spouse of an active duty military service

member who has relocated to Polk County pursuant to a permanent

change of station order upon providing a copy of the Change of Station

order.*

exemption is available to low-income individuals who are receiving public

the basis of Title IV-E(adoption assistance) and Title XIX of the Social

Security Act (Medicaid), temporary cash assistance, or food assistance

benefits upon providing a copy of the award letter.

discharged veterans, active duty military spouses, and low income

individuals who own a majority interest in a business with fewer than 100

employees upon providing documentation in support of the exemption

category and number of employees.*

Note: Exemptions generally do not apply to those who sell intoxicating

liquors, etc. or those who operate gaming devices. Also the local county

and are not transferrable.