DBPR HR-7010 Division of Hotels and Restaurants Notification of Change for Vacation Rental
2017 January Page 1 of 2
STATE OF FLORIDA, DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
Phone: 850.487.1395 Email: http://www.MyFloridaLicense.com/contactus/
Internet: www.myfloridalicense.com/DBPR/hotels-restaurants/
For Office Use Only
You may use this optional form to report the current list of all condominium or dwelling units
included in your vacation rental license. Please submit the completed form at least 60 days
before your license expiration date (Rule 61C-1.002(4)(a)2.b., F.A.C.). District mailing
addresses are available on the Division website or you may email the completed form to
TierN.DHRLicensing@myfloridalicense.com
File
Number
License
Number
Section 1 License Information
DBA Name
License Number
Owner Name
Contact Info (email/phone)
Total Units
Section 2 Condominium/Dwelling Information - Include all current rental units for the license
Please note the complete location address including county for each unit
County
Address
Unit #
Section 3 Applicant Signature
The information provided herein is true and correct to the best of my knowledge. The undersigned verifies that the
foregoing, including any attachments, is an accurate account of units represented for transient rental.
Print Name
Title
Signature
Date
DBPR HR-7010 Division of Hotels and Restaurants Notification of Change for Vacation Rental
2017 January Page 2 of 2
Please attach additional pages of information as necessary. Check here if additional pages are used.
Section 4 Additional Condominiums/Dwellings
DBA Name
License Number
Please note the complete location address including county for each unit
County
Address
Unit #
Email the completed from to: TierN.DHRLicensing@myfloridalicense.com