DriveLicAff by chrstphr

VIEWS: 2 PAGES: 1

									                                                    ALVIN R. MAZOUREK, CFA
                                                  HERNANDO COUNTY PROPERTY APPRAISER
                                                             PHONE: (352) 754-4190
    ♦ BROOKSVILLE OFFICE ♦                                                                              ♦ WESTSIDE OFFICE ♦
    201 Howell Avenue, Suite 300                                                                      7525 Forest Oaks Boulevard
    Brooksville, FL 34601-2041                                                                              Fax: (352) 688-5088
         Fax: (352) 754-4198                                                                           Addressing Fax: (352) 688-5060
     Homestead Fax: (352) 754-4194                                                                         Tangible Properties
                                                                                                      7509 Forest Oaks Boulevard
     “Save $$ Hundreds $$ -Apply by March 1st
             Don’t be the Exception ~
                                                                                                      Spring Hill, FL 34606-2400
                                                                                                        Tangible Fax: (352) 688-5087
      File for Your Homestead Exemption!”                Website: www.hernandocounty.us/pa
                                                                        1




T
O                                                              AFFIDAVIT


S
                        I, __________________________________________________, do hereby certify that I do not
E
R           have a valid Driver’s License in any State of Jurisdiction. This statement is to support my claim of Florida
V           residency for the purpose of obtaining Ad Valorem Tax Exemption under Section 196, Florida Statutes.
E


&                                                                                 ________________________________
                                                                                      Signature of Applicant


A
S
S
E
S           STATE OF FLORIDA
S           COUNTY OF HERNANDO

            The foregoing instrument was acknowledged before me on this ______ day of
W           _____________, 20_____, by ____________________________________ , who is
I
T           (personally known ) to me or who (produced ___________________ for identification)
H           and who (did) (did not) take an oath.


F
A
I
R
N                                               (Seal)                      Notary Public, State of Florida
E                                                                           Printed : ____________________________
S                                                                           My Commission Expires:
S

								
To top