DR-421
R. 11/12
Rule 12D-16.002
Florida Administrative Code
Effective 11/12
Certification for Taxing Authorities that
Do Not Levy Ad Valorem Taxes
Deadline: November 1
Indicate Change of Address:
I,
, Chief Administrative Officer of
the
, hereby certify that, pursuant
to section 218.23(1), Florida Statutes, the above named taxing authority has not levied ad valorem
taxes for the tax year
Signature of Chief Administrative Officer Phone Number
Title & Date of Certification
Fax Number
Please include your email address:
E-mail Address
Note:
This certification must be filed with the Department of Revenue no later than
November 1, of the tax year. Please return completed certification to :
Taxing Authority
.
Florida Department of Revenue
Property Tax Oversight - TRIM Section
P.O. Box 3000
Tallahassee, FL 32315-3000
Taxing Authority:
Mailing Address:
City, State, Zip:
County:
All TRIM forms for taxing authorities are available on our website at
http://floridarevenue.com/property/Pages/TRIM.aspx
click to sign
signature
click to edit
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