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DEALER TRANSACTION DETAIL WORKSHEET DATE: DEALER/TAG AGENCY NAME: AMOUNT: CHECK#: PIN: LICENSE #: TAG INFORMATION COMPLETED BY TAX COLLECTOR TITLE AND SALES TAX INFORMATION FAST TITLE WITH AFFIDAVIT DATE P R O C E S S E D R E J E C T E D TRANSFER NEW TAG 2 YEAR CLERK DUE SALES TAX TITLE ONLY TRANSFER ONLY PLATE # 01 TO 12 MOS. 13 TO 15 MOS. R E N E W APPLICANT'S NAME YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO DEALER DEPT. PHONES: FORT PIERCE ~ 772-462-3579 WALTON ~ 772-337-5743 TRADITION ~ 772-337-5602 EMAIL: [email protected] NO MORE THAN 10 TRANSACTIONS PER CHECK 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Rev 1/30/2020 Comments:

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Page 1: DEALER TRANSACTION DETAIL WORKSHEET

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: [email protected]

NO MORE THAN 10 TRANSACTIONS

PER CHECK

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Rev 1/30/2020

Comments:

mailto:[email protected]

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