Fillable form for multiple fee and license types. Refund (MyFloridaLicense)

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APPLICATION FOR REFUND FREQUENTLY ASKED QUESTIONS
1) If I need a refund for more than one fee or license type, should I
submit a separate refund form for each?
If the refunds are too numerous to list on the form, yes submit a
form for multiple fee and license types. Refund requests which are
not legible may be delayed.
2) Are all fee and license types refundable?
No, some are non-refundable. Refer to Customer Contact Center at
(850) 487-1395 or http://www.myfloridalicense.com/contactus/
3) How long will it take to receive my refund check?
The time will vary depending on the board or business area. It may
take as long as 8 weeks after the refund is received by the
appropriate business area.
4) Is it required that I print the form from the website?
No, however by doing so it will shorten the time needed to process
your refund.
IMPORTANT THINGS TO REMEMBER WHEN COMPLETING AN
APPLICATION FOR REFUND
1. In the upper portion of the form, provide all information in the highlighted areas. Provide
an application, file and/or license number if applicable. In the reason for claim section,
indicate the reason for the refund, for example: overpayment of exam fees, duplicate
payments, etc… Failure to provide all required information may result in delay of
payment.
2. Print, sign and date the application.
3. Mail the completed application (using the zip + 4 numbers listed below) to:
For Accountancy:
Division of Certified Public Accounting
240 NW 76 Drives, Suite A
Gainesville, Florida 32607
For Real Estate:
Division of Real Estate
400 W. Robinson Street, Suite N-801
Orlando, Florida 32801-1757
For all others:
Department of Business and Professional Regulations
1940 North Monroe Street
Tallahassee, Florida (use the applicable ZIP+4 Code from below)
Profession/Division ZIP+4 Code
Alcoholic Beverages and Tobacco 32399-1022
Architecture/Interior Design 32399-0771
Asbestos Licensing 32399-0767
Athlete Agents 32399-0767
Auctioneers 32399-0771
Barbers 32399-0790
Boxing Commission 32399-1016
Building Code Administrators & Inspectors 32399-0790
Child Labor 32399-2212
Community Association Managers 32399-0771
Condominiums, Timeshares & Mobile Homes 32399-1030
Profession/Division ZIP+4 Code
Construction Industry 32399-1039
Cosmetology 32399-0790
Drug, Devices and Cosmetics 32399-1047
Electrical Contractors 32399-0751
Employee Leasing Companies 32399-0767
Florida Building Commission
Farm Labor
32399-0772
32399-2212
Geologists 32399-0767
Hotels and Restaurants 32399-1011
Home Inspectors 32399-2214
Labor Organizations
Landscape Architecture
32399-2212
32399-0751
Mold Related Services 32399-2214
Pari-Mutuel Wagering 32399-1037
Pilot Commissioners 32399-0790
Talent Agents 32399-0771
Veterinary Medicine 32399-0751
Important Note:
In order to process your refund, section 215.26, Florida Statutes, requires all requests for refunds
be submitted within 3 years of the initial payment to the State of Florida.
Form BPR AA-4
Rev. 7/09
Pursuant to the provisions of Section 215.26, Florida Statutes, I hereby apply
for a refund, and that a State Warrant be drawn in the favor of:
Payee:
$
Address:
City: State: Zip:
$
Reason for Claim: $
Phone#: Application,File or License#:
$
Certified true and correct this day of , X
Month Year
Applicant Signature
DO NOT WRITE BELOW THIS LINE-DBPR PERSONNEL ONLY
FLAIR ACCOUNT CODE
PRTF 79-50-2-547001-79050100-00-000100
GENERAL REVENUE
PMW TAXES 79-74-1-000245-79100400-00-000300
OTP 79-74-1-000245-79400300-00-000320
OTP INTERNET TAXES 79-74-1-000245-79400300-00-000320 210.276
TRUST FUNDS
FLORIDA BOXING COMM. FEES 79-50-2-547001-79050400-00-000100
FLORIDA BOXING COMM. LICENSES 79-50-2-547001-79050400-00-000200
FLORIDA BOXING COMM. TAXES 79-50-2-547001-79050400-00-000300
FLORIDA BOXING COMM. MISC 79-50-2-547001-79050400-00-000400
FLORIDA BOXING COMM. FINES & BONDS 79-50-2-547001-79050400-00-001200
CHILD AND FARM LABOR 79-50-2-547001-79050600-00-000100 455
PMW TF FEES 79-20-2-520001-79100400-00-000100
PMW TF LICENSES 79-20-2-520001-79100400-00-000200
PMW TF TAXES 79-20-2-520001-79100400-00-000300
PMW TF MISC 79-20-2-520001-79100400-00-000400
PMW TF FEES 79-20-2-520001-79100400-00-001200
SLOT COM/ADDICTIVE GAMBLING 79-20-2-520001-79100500-00-000130
SLOT GENERAL OCC. LICENSE 79-20-2-520001-79100500-00-000132
SLOT BUSINESS OCC. LICENSE 79-20-2-520001-79100500-00-000133
SLOT PROFESSIONAL OCC. LICENSE 79-20-2-520001-79100500-00-000134
SLOT TAXES 79-20-2-520001-79100500-00-000335
SLOT FINES 79-20-2-520001-79100500-00-001200
SLOT MISCELLANEOUS REVENUE 79-20-2-520001-79100500-00-000400 550
H & R FEES 79-50-2-375001-79200100-00-000100
H & R LICENSES 79-50-2-375001-79200100-00-000200
H & R MISC 79-50-2-375001-79200100-00-000400
H & R FINES 79-50-2-375001-79200100-00-001200
DIV OF FLORIDA CONDOMINIUMS-FEES 79-50-2-289001-79800100-00-000100
DIV OF FLORIDA CONDOMINIUMS-LICENSE 79-50-2-289001-79800100-00-000200
DIV OF FLORIDA CONDOMINIUMS-MISC 79-50-2-289001-79800100-00-000400
DIV OF FLORIDA CONDOMINIUMS-FINES 79-50-2-289001-79800100-00-001200
AB&T FEES 79-20-2-022001-79400300-00-000100
AB&T LICENSE 79-20-2-022001-79400300-00-000200
AB&T TAXES 79-20-2-022001-79400300-00-000311
AB&T MISC 79-20-2-022001-79400300-00-000400
AB&T FINES 79-20-2-022001-79400300-00-001200
CIGARETTE TAX COLL.-TAXES. 79-74-2-086001-79400300-00-000312
CIGARETTE SURCHARGE 79-20-2-086001-79400300-00-000313 210.011
OTP SURCHARGE 79-20-2-086001-79400300-00-000319 210.011
Validation #: LicenseEase Year: Organization Code:
mm/dd/yyyy
Certified true and correct this________day of _______________, 20__________
Signature of Authorized Agency Person Title
……………………………………………………………FOLD LINE………………………………………………………………………………………………
…
561.19, 563.564, 565.02
210.04
561.12
561.19, 563.564, 565.02
548.035
550.09, 550.10
550.09
548.014, 548.075
AUTHORIZED
548.06, 548.061
565.12
548.035
548.025
ACCOUNT NAME
Object
Code
Refund
Amount
Application for Refund
Amount:
509.251, 509.261, 509.3
509.251, 509.261, 509.3
550.09
550.09
For Agency Use Only
STATUTE
455.219
550.09
550.09
550.09
550.09, 550.10
509.251, 509.261, 399.0
509.251, 509.261, 399.0
550.09, 550.10
550.09
550.09, 550.10
550.09, 550.10
561.19, 563.564, 565.02
561.19, 563.564, 565.02
498.017
498.017
498.017
498.017
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Completed 25 July 2021

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