dealer transaction detail worksheet

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DEALER TRANSACTION DETAIL WORKSHEETDATE: DEALER/TAG AGENCY NAME:

AMOUNT:CHECK#: PIN: LICENSE #:

TAG INFORMATIONCOMPLETED BY TAX COLLECTOR

TITLE AND SALES TAX INFORMATION

FASTTITLEWITH

AFFIDAVIT

DATE PROCESSED

REJECTED

TRANSFER NEW TAG

2YEAR

CLERK

DUE

SALESTAX

TITLEONLYTRANSFER

ONLYPLATE #

01TO12

MOS.

13TO15

MOS.

RENEW

APPLICANT'S NAME

YES NOYES NOYES NOYES NOYES NOYES NOYES NOYES NOYES NOYES NO

DEALER DEPT. PHONES: FORT PIERCE ~ 772-462-3579 WALTON ~ 772-337-5743 TRADITION ~ 772-337-5602 EMAIL: dealerinfo@tcslc.com

NO MORE THAN 10 TRANSACTIONS

PER CHECK

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Rev 1/30/2020

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