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City of Oldsmar Vending Machine Affidavit

  1. As a basis for the City of Oldsmar to issue a Business Tax Receipt in accordance with Ordinance 89-10 and subsequent amendment 2007-08, the undersigned hereby affirms the total number of vending machines at a site in the City of Oldsmar during the preceding twelve months is as follows: (New businesses can use an estimate for the current Receipt period.)

  2. Use one form for each Oldsmar address

  3. The Business Tax Receipt fee is $15.00 per machine.

  4. By typing your name here, you are signing this form electronically. You agree you are submitting this affidavit for processing and is the legal equivalent of your manual signature on this form. You must be the legal business owner or authorized agent which match our registration records. Note: A notarized Letter of Authorization is required for an agent to sign the application or any other correspondence that calls for an agent signature.

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