Fillable Dr408a F DR 408A N 2/91

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Dr408a F DR 408A N 2/91

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CERTIFICATE TO
NON-AD VALOREM ASSESSMENT ROLL
DR-408A
N. 02/91
I, the undersigned, hereby certify that I am the Chairman of the Board, or authorized
agent of
Florida; as such, I have satisfied myself that all property included or includable on the
Non-Ad Valorem Assessment Roll for the aforesaid county is properly assessed so far
as I have been able to ascertain; and that all required extensions on the above
described roll to show the non-ad valorem assessments attributable to the property
listed therein have been made pursuant to law.
I further certify that, upon completion of this certificate and the attachment of same to
the herein described Non-Ad Valorem Assessment Roll as part thereof, said Non-Ad
Valorem Assessment Roll will be delivered to the Tax Collector of this county.
In witness whereof, I have subscribed this certificate and caused the same to be
attached to and made a part of the above described Non-Ad Valorem Assessment Roll
this the day of , .
County,
, located in
year
Chairman of the Board or authorized agent
Name of local government
of
County, Florida
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Dr408a F DR 408A N 291

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Completed 4 November 2019

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