Alt. Key:
(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
