Property management company local mailing address: please check one: initiated by


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(PLEASE ATTACH COPY)

LENDER/ LIEN HOLDER:

CONTACT:

LENDER/ LIEN HOLDER MAILING ADDRESS:

PROPERTY MANAGER:

    BUSINESS LICENSE #:

CONTACT:

PROPERTY MANAGEMENT COMPANY LOCAL MAILING ADDRESS:

PLEASE CHECK ONE: 

INITIATED BY:

PRINT NAME

SIGNATURE

DATE

COMPANY NAME 



ADDRESS 

PHONE#


AN ANNUAL REGISTRATION FEE SHALL ACCOMPANY THIS REGISTRATION FORM. THE FEE AND REGISTRATION SHALL BE VALID 

FOR THE CALENDAR YEAR, OR REMAING PORTION OF THE CALENDAR YEAR IN WHICH THE REISTRATION WAS INITIALLY 

REQUIRED. SUBSQUENT REGISTRATIONS AND FEES ARE DUE JANUARY 1ST OF EACH YEAR AND MUST BE RECEIVED NO LATER 

THAN JANUARY 31ST OF THE YEAR DUE. REGISTRATION FEES WILL NOT BE PRORATED [FPMC 103.03]

CONTACT PHONE:

REGISTERED RESIDENCE ADDRESS:

ASSESOR PARCEL NUMBER:

NOTICE OF DEFAULT RECORDATION #:

    24 HR PHONE #:

        NEW REGISTRATION                  RENEWAL

CITY OF FRUITLAND PARK

PLANNING DEPARTMENT

STANDARD ANNUAL FEE: 



$250.00

PLEASE FILL OUT THE INFORMATION REQUESTED BELOW AND DELIVER THIS FORM TO THE PLANNING DEPARTMENT                  OR 

MAIL TO : THE CITY OF FRUITLAND PARK, 506 W. BERCKMAN ST., FRUITLAND PARK, FL 34731

REGISTRATION FORM FOR ABANDONED RESIDENTIAL PROPERTY


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