HomeMy WebLinkAboutAgreement_General_02/09/2012 (2) Forsythe, Jody
From: Local- Govt -Unit [Local- Govt - Unit @dor.state. fl. us]
Sent: Monday, December 19, 2011 3:37 PM
To: Local- Govt -Unit
Subject: RESEND- attachment issues for CST agreement
Attachments: CST Confidentiality Agreement blank - 052232011.pdf
The Florida Department of Revenue has changed the process for renewing the Agreement for the
Communications Services Tax (CST) Information Sharing Website. This change in procedure is in effort to
ease the process for the Local Governments as well as the Florida Department of Revenue.
Previously these agreements were effective for three (3) years from the time of receipt for each individual
Local Government submission. Agreements required renewal at random times throughout the year for
individual Local Governments.
We are altering this process by implementing a set effective date of termination for all agreements every three
years. Renewal requests will be sent to all Local Governments prior to this set Agreement termination.
If a modification to the three year Agreement is requested during the three year duration, the changes will be in
effect until the next scheduled renewal process.
Scheduled Renewal Process Effective Beginning Date Effective Termination Date
October to December 2011 January 1, 2012 December 31, 2014
October to December 2014 January 1, 2015 December 31, 2017
October to December 2017 January 1, 2018 December 31, 2020
October to December 2020 January 1, 2021 December 31, 2023
Please complete and return the attached Communications Services Tax Agreement and Addendum to:
Paul Fultz, Disclosure Officer
Florida Department of Revenue
PO Box 6668
Tallahassee, FL 32314 -6668
or
Fax Agreement to: 850 -921 -4711
E -mail Agreement to: fultzp(cr�,dor. state. fl.us
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ZI � IS °.
1
Communications Services Tax
Agreement for Access to Confidential State Tax Information
between
// tflowroTme_ and the Florida Department of Revenue
ocal Government Name)
1. The Florida Department of Revenue, acting in its cap city as coordinator of the Communications Services Tax (CST) Information
Sharing Website, and \) 1 t?S Local Government) enter into this Agreement for the sharing of certain
information specified in s. 213,00(8)(v), Florida Statutes (F.S.).
2. According to s. 213.053(8), F.S., when in receipt of information shared under this Agreement, the Local Government, its
employees, its contractors, and any other person who may have access to confidential information obtained by the Local
Government under this agreement shall be bound by all applicable laws imposing confidentiality requirements. These
requirements include, but may not be limited to, those stated in s. 213.053, F.S., and Chapter 12 -22, Florida Administrative Code.
Violation of confidentiality requirements is a misdemeanor of the first- degree, punishable as stated in ss. 775.082 and 775.083,
F.S., by up to one year in prison and/or fines up to $1000.
3. As stated in s. 213.053(2), F.S., all information contained in returns, reports, accounts, or declarations related to or identifying
specific taxpayers is confidential. The Local Government and the person(s) designated below agree to take appropriate steps to
protect confidential information obtained from the Department of Revenue under this agreement from unauthorized use or
disclosure.
4. The Local Government and the person(s) designated below agree that confidential state tax information will be kept in a secure
environment, and will only be used for official tax administration purposes. When no longer needed, tax information obtained
from the Department must be destroyed by shredding, incineration, pulping, or other appropriate means to make the information
unreadable. Shredded paper should be 5116 inch wide or smaller and, if not using a cross -cut shredder, paper should be fed into
the shredder with lines of print perpendicular to the cutting blades of the shredder. If incinerating, the incinerator should produce
enough heat to burn the entire bundle, or the bundle should be separated to ensure all pages are burned. If pulping, the process
should reduce all material to particles one inch or smaller.
5. Only the employees of the Local Government with an official need and use will be allowed to request, receive, and review state
tax information. The Local Government agrees that confidential state tax information obtained from the Department will be
shared only with persons with direct responsibility for budget preparation, auditing, revenue or financial administration, or legal
counsel, and may only be used for purposes related to budget preparation, auditing, and revenue and financial administration.
Confidential and exempt information may not be further disclosed by the recipient unless meeting these stated criteria.
6. Each authorized employee as stated in paragraph 5 above is required to execute the certification of familiarity with the
confidentiality requirements of x.213.053, F.S., and Chapter 12 -22, F.A.C., found in the Addendum to this agreement. Any
person who becomes an authorized employee subsequent to the signing of this agreement must execute a separate certification of
familiarity. In each instance, certifications shall be forwarded to the Department of Revenue Security & Disclosure Officer
within 15 business days of hire date or change of employment status, with a cover letter signed by the Local Government
signatory to this agreement.
7. The Local Government shall notify the Department of Revenue Disclosure Officer in writing within 15 business days when any
signatory of this Agreement leaves employment or changes employment status such that he or she no longer has an official use for
the information.
8. Effective Date
This Agreement shall be effective on the date all parties have signed the Agreement.
9. Duration and Termination
A. This Agreement shall terminate three (3) years from the effective date.
B. Either party may terminate this Agreement upon no less than thirty (30) calendar days notice, without cause, unless the
parties mutually agree upon a lesser time. Said notice shall be in writing, delivered by certified mail, return receipt requested,
or in person with proof of delivery.
10. Legal Requirements
I
A. With respect to its interpretation, construction, effect, performance, enforcement, and all other matters, this Agreement shall
I be governed by, and be consistent with, the whole law of the State of Florida, both procedural and substantive. Any and all
litigation arising under this Agreement shall be brought in the appropriate State of Florida court in Leon County, Florida.
B. Each party hereto agrees that it shall be solely responsible for the wrongful act of its employees, contractors, and agents.
However, nothing contained herein shall constitute a waiver by either party of its sovereign immunity and the limitation set
forth in section 768.28, Florida Statutes.
C. The failure of either party to this Agreement to object to or to take affirmative action with respect to any conduct of the other
which is in violation of the terms of this Agreement shall not be construed as a waiver of any existing violation, breach,
wrongful conduct; or of any future violation, breach, or wrongful conduct.
11. Modification
Modification of this Agreement shall only be valid when reduced to writing and duly signed. The parties agree to renegotiate this
Agreement if revisions of applicable Federal and/or State statutes and regulations make changes necessary; or when either party
deems such action appropriate in the administration of the laws.
12. Severability
If any provision of this Agreement or the application of it is determined to be invalid for any reason, such determination shall not
affect the validity of other provisions or applications of the Agreement which can be given effect without the invalid provision or
application. To this end, the provisions of this Agreement are declared to be severable.
13. The Local Government designates the following person to receive password and user identification information for accessing the
CST Information Sharing Website, and to control access to the CST Information Sharing Website:
Name (print) J Off`/ r YIE�� Title r l n D 1 <
Mailing Address U /ZIP 331-t
S S
� � t 1) ri city/ZIP ty
Phone Number — 7(oY — C � @ _Q E -mail Address
C �
14. This Agreement must be signed by the local government representative and the Florida Department of Revenue. Please sign and
date in the space below. A copy of the Agreement, signed by the Florida Department of Revenue, will be returned to you.
Approved by Local Government: Approved y Florida Department of Revenue:
Signa a Signature �G�
Title f Executive Director
/ Florida Department of Revenue
Date G l' Date
Please return your signed Agreement and Addendum to Paul Fultz, Disclosure Officer.
By e-mail to: fultzp @dor.state.fl.us
By fax to: 850- 488 -7112
By mail to:
Paul Fultz, Disclosure Officer
Florida Department of Revenue
PO Box 6668
Tallahassee, FL 32314 -6668
ADDENDUM
Communications Services Tax
Agreement for Access to Confidential State Tax Information
between
I a Ttt and the Florida Department of Revenue
(Local Government Name)
Designee's Certification
As the person designated in paragraph 13 of this agreement to receive password and user identification information for accessing
the CST Information Sharing Website, and to control access to the CST Information Sharing Website, I certify that I am familiar
with the confidentiality requirements of s.213.053, F.S., and aware that the unauthorized use or disclosure of state tax information
is a misdemeanor of the first degree punishable as stated in ss. 775.082 and 775.083, F.S., by up to one year in prison and/or fines
up to $1000. I understand that confidential state tax information obtained from the Department of Revenue may be used only for
official purposes related t e rep ation an revenue and financial a ation
Designee signature Date ZI 7�
Other Authorized Employees
As an authorized employee or contractor of the local government, I certify that I am familiar with the confidentiality requirements
of s. 213.053, F. S., and aware that the unauthorized use or disclosure of state tax information is a misdemeanor of the first degree
punishable as stated in ss. 775.082 and 775.083, F.S., by up to one year in prison and/or fines up to $1000. 1 understand that state
tax information received from the Department of Revenue may be used only for official purposes related to budget preparation,
auditing, and revenue and financial administration
Name (print a 1 7C� eQ Co !') c� 7 J Title & � �' �e C y C f
Signatur Dat / /
Name (print) Title
Signature Date
Name (print) Title
Signature Date
Name (print) Title
Signature Date
Name (print) Title
Signature Date
Name (print) Title
Signature Date