CITY OF MIAMI PARKING SURCHARGE
ANNUAL REGISTRATION FORM
2009 - 2010
PROPERTY NUMBER     This number refers to this property only.  Please reference on all remittances.
FACILITY INFORMATION
                           
FACILITY ADDRESS            FACILITY NAME        
(Location address should be the same address as listed on the Business Tax Receipt and Certificate of Use for this facility)
CITY OF MIAMI BUSINESS TAX RECEIPT NUMBER              
CITY OF MIAMI CERTIFICATE OF USE NUMBER              
Location Start Date      
  Former Operator              
MAXIMUM VEHICLE CAPACITY     (If start date is after 9/1/99)  
                           
WHICH OF THE FOLLOWING BEST DESCRIBES THIS FACILITY?
   
Surface Lot
Garage (free standing)
Garage (attached to building)  
Garage w/ Surface Lot
Wrecker Storage
Repair Shop Storage  
  Is this facility used for Valet Parking?            Yes                  No
Other ______________________
                           
WHICH OF THE FOLLOWING BEST DESCRIBES THE CONTROLS FOR LEASED (MONTHLY) PARKING FOR THIS FACILITY?
   
Hangtags
Electronic Control Cards with Access Gates  
Permits or Decals
Other - Please Explain:              
                           
CHECK ALL OF THE FOLLOWING THAT DESCRIBE THE CONTROLS FOR VISITOR/TRANSIENT PARKING FOR THIS FACILITY?
   
Manually Issued Tickets  
Manual Collection of Revenue  
Automatic Ticket Dispensing Machine
Attendant Operated Fee Computer  
Unattended Facility with Coin Machine, Meters or Honor Box  
Other - Please Explain:                    
                           
FOR WHAT TYPE OF PARKING IS THIS FACILITY USED?
   
Leased (Monthly) Parking
Visitor (transient) Parking
Vehicle Storage   
# of spaces   # of spaces   # of spaces      
                           
                           
RATE INFORMATION (Before Sales Tax and Surcharge)
Please describe in detail all of the various rates for this facility.
Please include all monthly (lease), daily (incremental), flat, event, weekend rates, etc.
   
   
   
   
   
   
                           
All parking operators and/or owners must notify the City in writing of any changes in their parking rates within seven (7) days
PROPERTY OWNER INFORMATION     PROPERTY NUMBER    
   
check here if owner is to receive correspondence regarding the parking surcharge  
OWNER'S NAME                    
(Owner's name as appears on the Miami-Dade Property Tax files)  
CONTACT          
ADDRESS                      
CITY     STATE   ZIP      
PHONE NUMBER (               )       FAX NUMBER (               )      
EMAIL ADDRESS              
                           
OPERATOR INFORMATION                
 
 
  check here if operator is to receive correspondence regarding the parking surcharge  
OPERATOR'S NAME                    
CONTACT          
ADDRESS                      
CITY     STATE   ZIP      
PHONE NUMBER (               )       FAX NUMBER (               )      
EMAIL ADDRESS              
                           
Attachment: (Your registration will not be processed without this information)
Attach a schematic or drawing of parking facility perimeters.  Include the names and/or numbers of the streets bordering the facility and
indicate all entrances and exits.  Please notify our office of any alterations made to any location by way of a revised drawing within seven (7)
days of any alteration.
              (             )    
Signature of Business Tax Receipt Applicant Date Telephone
Return completed form to: The Parking Network
Parking Surcharge Administration
2650 Biscayne Boulevard
Miami, FL 33137
(305) 571-1951
FOR OFFICE USE ONLY:                      
   
Verified and Entered by:       Date: