Florida Application for Rescindment of Tax Credit Allocation for Contributions to Nonprofit Scholarship Funding Organizations (SFOs) R.07/11

Application for Rescindment of Tax Credit Allocation for Contributions to Nonprofit Scholarship Funding Organizations (SFOs) R.07/11
Form DR-116100
Florida Tax Credit Scholarship Program
Application for Rescindment of Previous Allocation of Tax Credit
Under sections (ss.) 211.0251, 212.1831, 220.1875, 561.1211, 624.51055,
and 1002.395, Florida Statutes, (F.S.)
Business Name:

DR-116100
R. 01/25

Rule 12-29.003, F.A.C.
Page 1 of 2

Federal Employer Identification Number (FEIN):

Mailing Address:
City, State, ZIP:

Contact Person:
Contact Person’s Email Address*:

Contact’s Telephone Number:

*Your privacy is important to the Florida Department of Revenue. Email addresses provided to the Department for tax
administration purposes are confidential and exempt from disclosure under section 213.053(2), F.S.
Florida Law requires you to authorize the Florida Department of Revenue to respond to you using unencrypted email that does
not require additional steps before you can access information in the email. To expedite the processing of your application,
you may wish to receive unencrypted email regarding this application. If so, indicate your approval to receive unencrypted
email by selecting ‘Yes’ below, otherwise, select ‘No.’
o Yes. I authorize the Florida Department of Revenue to send information regarding this application using unencrypted email.
o No. I wish to receive encrypted emails from the Florida Department of Revenue. (The software used to encrypt email
requires a one-time passcode or a user account.)
If included in a Consolidated Florida Corporate Income Tax Return, provide the following.
Parent Corporation’s FEIN:

Original amount of planned contribution: $

Confirmation Number of Original Credit Allocation Application:
Enter the Name of the SFO the Credit was Originally Approved for:
Enter the Amount You Wish to Rescind: $

Enter the amount(s) below to rescind based on the tax type. (The sum of the amounts by tax cannot exceed the total amount you
wish to rescind above. The amount to be rescinded for each tax cannot exceed the amount allocated to that tax on the original
application.)
$ __________________________________________ Corporate Income Tax (Chapter 220, F.S.)
$ __________________________________________ Insurance Premium Tax (s. 624.509, F.S.)
$ __________________________________________ Excise Tax on Malt Beverages (s. 563.05, F.S.)
$ __________________________________________ Excise Tax on Wine Beverages (s. 564.06, F.S.)
$ __________________________________________ Excise Tax on Liquor Beverages (s. 565.12, F.S.)
$ __________________________________________ Sales Tax Paid by a Direct Pay Permit Holder (s. 212.183, F.S.)
$ __________________________________________ Tax on Oil Production (s. 211.02, F.S.)
$ __________________________________________ Tax on Gas Production (s. 211.025, F.S.)
I understand that s. 1002.395(5)(f), F.S., requires the Florida Department of Revenue to provide a copy of any approval or denial it
issues with respect to this application for rescindment to the nonprofit scholarship-funding organization indicated on the associated
application for an allocation of credit.
Under penalty of perjury, I declare that I have read this application form and that the facts stated in it are true.
Signature of officer, owner, or partner

Date

DR-116100
R. 01/25
Page 2 of 2

Instructions for Completing Form DR-116100
You may apply to the Department for rescindment of all
or part of a previously approved allocation of tax credit
under the Florida Tax Credit Scholarship Program using the
Department's website at floridarevenue.com/taxes/sfo.
You must submit a separate application for the rescindment
of each previously approved credit allocation.
Once you have entered the requested information, a
confirmation screen with a confirmation number will appear.
This screen will display the information entered and confirm
receipt of the electronic application for rescindment. You
can print this screen or simply record the confirmation
number to prove that you submitted an application for
rescindment.
If you don't have your original confirmation number, contact
the Revenue Accounting section at 850-617-8586.

The Department will send written correspondence
regarding the approved rescindment amount or the reason
the rescindment request could not be approved.
The Department will approve the rescindment unless:
(1)	 You have claimed the credit amount to be rescinded on
a previously filed tax return.
(2)	 The allocation year is closed for all taxpayers. The
allocation for a particular year is closed for all taxpayers
on October 1st of the third year after the January 1
opening of the allocation period. For example, the
allocation year beginning January 1, 2018, for the
state fiscal year beginning July 1, 2018, closes for all
taxpayers on October 1, 2020, regardless of whether
the annual allotment has been reached because
October 1, 2020, is the extended due date of the last
tax year beginning in the 2018 calendar year (tax year
beginning December 1, 2018, and ending November
30, 2019, with a due date of April 1, 2020, and
extended due date of October 1, 2020).