| 1. Enter the license plate fee from the Trailer Rate Chart | $_______ |
| Add $12.00 when new metal license plate is to be issued (If transferring a valid Florida license plate, see number five below.) | $_______ |
| 2. Title fee (if applicable), enter $29.25 for new trailers previously titled in Florida; $33.25 for trailers previously titled in another state NOTE Trailers weighing 1,999 lbs. or less will not require a title. | $_______ |
| 3. If recording a lien, enter $2.00 NOTE: This fee only applies if the empty weight of the trailer is 2,000 lbs. or more. | $_______ |
| 4. If over 30 days from the date of purchase, enter $10.00 NOTE: This fee only applies if the empty weight of the trailer is 2000 lbs. or more | $________ |
| 5. If transferring a valid Florida license plate to a replacement trailer, enter $8.60 | $_______ |
| 6. Must comply with separate sales tax notice enclosed. If sales tax due, enter amount | $_______ |
| 7. Amount due: Enter total of above lines 1-6 | $________ |
| 8. Enter the total from line 7 on your check, made payable to Rod Northcutt, Tax Collector | ________ |
| 9. Proof of ownership A) New Trailers: Manufacturer's certificate of origin B) Used Trailers: Certificate of title from a title state, or registration must be submitted from a non-title state or foreign country | ________ |
| 10. All required application forms completed and signed | ________ |