Free DR-15SWS - Florida

Schedule of Rental Car Surcharge by County
(Submit with Solid Waste and Surcharge Return, Form DR-15SW)

DR-15SWS R. 01/05

Certificate number: Business partner number: Collection period:
Name Address City/St/ZIP

Enter the number of days, by county, that all motor vehicles were leased or rented during the month (count only the days that represent the first 30 days, or portion thereof, a vehicle is continuously leased or rented to one lessee or rentee) minus the number of days on which the surcharge has been written off as a bad debt for federal income tax purposes, or other lawful deductions. Include this schedule with your Solid Waste and Surcharge Return (Form DR-15SW).

Alachua (11) Baker (12) Bay (13) Bradford (14) Brevard (15) Broward (16) Calhoun (17) Charlotte (18) Citrus (19) Clay (20) Collier (21) Columbia (22) Dade De Soto (24) Dixie (25) Duval (26) Escambia (27) Flagler (28) Franklin (29) Gadsden (30) Gilchrist (31) Glades (32) Gulf (33) Hamilton (34)

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See Miami-Dade

Hardee (35) Hendry (36) Hernando (37) Highlands (38) Hillsborough (39) Holmes (40) Indian River (41) Jackson (42) Jefferson (43) Lafayette (44) Lake (45) Lee (46) Leon (47) Levy (48) Liberty (49) Madison (50) Manatee (51) Marion (52) Martin (53) Miami-Dade (23) Monroe (54) Nassau (55) Okaloosa (56)

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Okeechobee (57) Orange (58) Osceola (59) Palm Beach (60) Pasco (61) Pinellas (62) Polk (63) Putnam (64) St. Johns (65) St. Lucie (66) Santa Rosa (67) Sarasota (68) Seminole (69) Sumter (70) Suwannee (71) Taylor (72) Union (73) Volusia (74) Wakulla (75) Walton (76) Washington (77) Total number of rental days
(Carry forward to Column A, Line 4 of the return)

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