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Ken BurKe, C.P.A.
ClerK of the CirCuit Court And ComPtroller
PinellAs County, floridA
www.mypinellasclerk.org
08/2015
Tenant Rights
TENANT RIGHTS
****** Important Information ******
A tenant eviction is the legal procedure a landlord must follow to have a tenant removed from
the landlord’s property.
REFER to chapters 45 through 57 and chapter 83 of the Florida Statutes for information
regarding tenant eviction cases.
Copies of these statutes are available at the law library located at the Clearwater
Courthouse, at your public library or online through the Florida Legislature website at
http://www.leg.state.fl.us/Statutes
REVIEW the Quick Reference Guide prior to completing any forms.
RETAIN COPIES of all forms filed for your records.
DOCUMENTS MUST BE LEGIBLE, type written or legibly handwritten in black or blue ink.
IT IS IMPORTANT that the names and addresses are the same on all documents.
A DELAY CAN OCCUR as a result of any errors on your paperwork.
PAY TO THE CLERK OF THE COURT the rent that is due as set forth in the landlord’s
complaint or as determined by the court once you have been served by a summons. You MUST
pay the Clerk the rent each time it becomes due until the lawsuit is over.
YOU MUST PROVIDE self-addressed stamped envelopes and/or copies for each party for any
issue requiring the Judge’s signature or your issue WILL NOT be reviewed by the court.
Information or forms provided by the Clerk of the Circuit Court should be considered as basic
information only and may not be applicable to every situation. The information provided in this
packet is not intended to be used as legal advice. Specific guidance concerning filing a lawsuit
or questions about your particular situation should be directed to an attorney.
YOU CAN BRING YOUR COMPLETED FORMS TO ANY ONE OF THE
FOLLOWING OFFICES OR MAIL TO CIVIL COURT RECORDS:
Civil Court Records North County Branch Office St. Petersburg Branch Office
315 Court Street Room 170 29582 US Highway 19 North 545 1
st
Avenue North
Clearwater, FL 33756 Clearwater, FL 33761 St. Petersburg, FL 33701
If you have any questions, you may contact us at 727-464-7000.
If you feel you need further assistance or require any legal assistance regarding the completion
and/or filing of these forms, you may want to contact an attorney or visit the Self Help Center.
SELF HELP CENTER
The Self Help Centers are the result of a collaborative effort between the Clerk’s Office, the Sixth Judicial Circuit,
the Community Law Program and the Clearwater Bar Association.
The purpose of the Clerk's Legal Self Help Centers is to assist citizens representing
themselves in court (sometimes referred to as pro se persons) who do NOT have a private attorney.
Citizens who represent themselves in court and do not already have a private attorney representing them, can
now get affordable legal assistance.
OUR SERVICES INCLUDE:
• Schedule an appointment to consult with an attorney for a minimum of $15.00*
(Attorneys may assist with Family Law, Small Claims and Landlord/Tenant matters ONLY.)
• Purchase forms and packets for the civil court actions listes above
• Have documents notarized
• Make copies
Open Monday through Friday from 8:30 a.m. until 4:30 p.m.:
•
The Clearwater Self Help Center
The Clearwater Law Library, Old Clearwater
Courthouse
315 Court Street,
Clearwater, FL 33756
Phone: (727) 464-5150
Fax: (727) 453-3423
o Appointments may be scheduled for
Thursday and/or Friday.
o A Spanish interpreter provided by the
Hispanic Outreach Center is available by
appointment at the Clearwater location
on Fridays from 10:00 a.m. until 12:00 p.m.
•
The St. Petersburg Self Help
Center
The St. Petersburg Judicial Building
545 First Avenue North
St Petersburg, FL 33701
Phone: (727) 582-7941
Fax: (727) 582-7945
o Appointments may be scheduled for
Monday, Wednesday, and/or Friday.
• The North County Branch Self Help Center
29582 U.S. 19 North
Clearwater, FL 33761
Phone: (727) 464-5150
Fax: (727) 453-3423
o Attorney appointments may be scheduled
for Tuesday only at this office.
Self Help Center Now Offering Online Scheduling of attorney consultation appointments for pro se litigants
that do not already have an attorney. To schedule an appointment online using a credit card, please visit
www.mypinellasclerk.org
and click on the SELF HELP CENTER link in the top menu.
*Attorney appointments may only be scheduled for a minimum of 15 minutes to a maximum of one hour. All appointments must be
scheduled in 15-minute increments, i.e., 15, 30, 45 or 60 minutes at a rate of $1 (one dollar) per minute, therefore payments will be $15, $30,
$45 or $60 accordingly.
Attorney consultation fees must be paid when the appointment time is scheduled. Payments must be by credit card,cash check or money
order. Refunds will not be issued for missed appointments.
Ken Burke, CPA
Clerk of the Circuit Court
& Comptroller
Pinellas County, Florida
Florida Landlord/Tenant Law Division of Consumer Services, DOACS (1 of 4) Tenant Rights
LANDLORD/TENANT INFORMATION
Most renters are aware they have certain rights when they are involved in a dispute with their
landlord, however they often don't know what those rights are. This information sheet was
developed to answer many of the questions frequently asked about landlord/tenant relationships.
Deposit and Rent Requirements
Section 83.49(a), F. S.
When you move out, the landlord must either return your deposit within 15 days of termination of
the rental agreement, if the landlord does not intend to impose a claim upon the security deposit; or
justify in writing by certified mail, to the tenant's last known mailing address within 30-days upon
termination of a rental agreement, as to why they are keeping a portion of or all of the deposit. If the
notice is not sent as required within the 30-day period, the landlord forfeits his/her right to impose a
claim upon the deposit, unless you fail to give proper notice prior to vacating.
Section 83.49, 3(b)(c), F. S.
Unless you object to the imposition of the landlord’s claim or the amount thereof within 15 days
after receipt of the landlord’s notice of intention to impose a claim, the landlord may then deduct
the amount of his or her claim and shall remit the balance of the deposit to you within 30 days after
the date of the notice of intention to impose a claim for damages. If you object to the landlord’s
claim you may file a complaint with the Department of Agriculture and Consumer Services or
institute an action in a court of competent jurisdiction to adjudicate the landlord’s right to the
security deposit.
Who is Responsible
You and your landlord share many of the responsibilities. Maintenance of the premises is a good
example. Your landlord must provide a healthy, properly maintained place for you to live. You are
required to keep the premises in good condition and to occupy them as a peaceful neighbor.
There are certain responsibilities that apply to each party as outlined by law.
The Landlord
Section 83.51(1), F.S.
The landlord's responsibilities will depend on the type of rental unit. The landlord of a dwelling unit
at all times during the tenancy shall:
Section 83.51(1)(a)(b), F.S.
Comply with the requirements of applicable building, housing and health codes; or
Where there are no applicable building, housing or health codes; maintain the roof,
windows, screens, floors, steps, porches, exterior walls, foundations and all other structural
components in good repair and capable of resisting normal forces and loads;
Keep the plumbing in reasonably good working condition.
The landlord's obligations may be altered or modified in writing with respect to a single family
dwelling or duplex.
Florida Landlord/Tenant Law Division of Consumer Services, DOACS (2 of 4) Tenant Rights
Section 83.51(2)(a), F.S.
In addition to providing the above requirements, the landlord of a dwelling unit other than a single-
family home or duplex shall, at all times of the tenancy, make reasonable provisions for:
Extermination of rats, mice, ants and wood destroying organisms and bed bugs.
Locks and keys.
Clean and safe conditions of common areas.
Garbage removal and outside receptacles.
Functioning facilities for heat during winter, running water and hot water.
Section 83.51(2)(b), F.S.
If the dwelling is a single-family home or duplex, a working smoke detection device.
This does not mean that the landlord is obligated to pay for utilities, water, fuel or garbage removal,
although he/she may choose to. Other provisions relevant to a rental agreement may also be altered
in writing.
The Tenant
Section 83.52, F.S.
A tenant, at all times during the tenancy shall:
Comply with all building, housing and health codes.
Keep the dwelling clean and sanitary.
Remove garbage from the dwelling in a clean and sanitary manner.
Keep plumbing fixtures clean, sanitary and in repair.
Not destroy, deface damage, impair or remove any part of the premises or property
belonging to the landlord, nor permit any person to do so.
Conduct themselves and require other persons on the premises with his/her consent, to
conduct themselves in a manner that does not unreasonably disturb the tenant's neighbors or
constitute a breach of the peace.
Use and operate in a reasonable manner all electrical, plumbing, sanitary, heating,
ventilating, air-conditioning and other facilities and appliances, including elevators.
Access to the Premises
Section 83.53(2), F.S.
Once you agree to rent a dwelling, your right to possession is much the same as if you owned it.
The landlord however, can enter at reasonable times with proper notice to inspect, make necessary
or agreed repairs, decorations, alterations or improvements, supply agreed services or show it to a
prospective or actual purchaser, tenant, mortgagee, worker or contractor.
The landlord may also enter at any time when:
The tenant has given consent;
In an emergency;
The tenant unreasonably withholds consent; and/or,
The tenant is absent from the premises for a period of time equal to one-half the time for
periodic rental payments. If the rent is current and the tenant notifies the landlord of an
intended absence, then the landlord may enter only with the consent of the tenant or for the
protection or preservation of the premises.
Florida Landlord/Tenant Law Division of Consumer Services, DOACS (3 of 4) Tenant Rights
Failure to Meet Obligations
Except for the failure to pay rent, a landlord must notify you in writing of any shortcomings and
give you seven days in which to correct the situation. If you still have not complied after seven
days, the landlord can begin the eviction process based on non-compliance.
If the Landlord Does Not Comply
Section 83.56 (1), F.S.
You may be able to withhold rent if your landlord fails to do what the law or rental agreement
requires. You must however, announce your intentions in writing by mail, preferably certified, at
least seven days before the rent is due to allow time to remedy the problem.
If the problem is not corrected within the seven days and you withhold the rent, the landlord may
take you to court to collect it. Under these circumstances, you must pay the rent into the court
registry, pending the judge's determination in the case.
If the Tenant Does Not Comply
Section 83.56(2), F.S.
You can be evicted for not living up to the agreement. The process of removal depends on the
breach.
Evictions Other Than Non-Payment of Rent
Section 83.56(2)(a), F.S.
Under certain circumstances, if you have exhibited a lack of consideration for the rights and privacy
of others, a landlord has the right to require you to move with very little notice.
In some cases (destruction, damage, misuse of property, unreasonable disturbances), the landlord
does not have to give you an opportunity to remedy the problem and may terminate tenancy by
giving you a seven-day written notice.
Each eviction case is unique, so be sure to obtain legal advice. A landlord MAY NOT evict you
solely in retaliation for the tenant complaining to a governmental agency about code violations or
asserting other tenant rights.
Eviction for Non-Payment of Rent
Section 83.56(3), F.S.
The landlord must serve you, the tenant, a written notice allowing three days (excluding weekends
and legal holidays) for you to pay the rent or move from the premises. If you do not pay the rent or
move, he/she may begin legal action to evict you.
In order for the landlord to gain payment of rent or possession of the dwelling, he/she must file suit
in county court.
If the landlord began a legal action to evict you, you will be notified in writing. You then have five
days (excluding weekends and legal holidays) to respond – also in writing – to the court. If you do
not respond and a judgment is entered against you, the clerk of the county court may issue a “Writ
of Possession” to the sheriff who will notify you that eviction will take place in 24 hours.
Florida Landlord/Tenant Law Division of Consumer Services, DOACS (4 of 4) Tenant Rights
Section 83.57, F.S.
Termination of tenancy without a specific term - days of written notice required (prior to
termination):
Weekly --------- 7 days
Monthly -------- 15 days
Quarterly ------- 30 days
Yearly ---------- 60 days
Section 83.67, F.S.
Florida Law does not allow a landlord to force a tenant out by:
Shutting off the utilities or interrupting service, even if that service is under the control of or
the landlord makes payment;
Changing the locks or using a device that denies the tenant access;
Removing the outside doors, locks, roof, walls or windows (except for purposes of
maintenance, repair or replacement); and/or
Removing the tenant's personal property from the dwelling unless action is taken after
surrender, abandonment, recovery of possession of the dwelling unit due to the death of the
last remaining tenant in accordance with section 83.59(3)(d), or lawful eviction.
If any of these occur, the tenant may sue for actual and consequential damages or three months' rent,
whichever is greater, plus court costs and attorney's fees.
When You Decide to Move
Don't forget to give the required notice as stated in your rental agreement. The information below
indicates appropriate notification if a specific time period is not included in the rental agreement. Be
sure to check your rental agreement for any other specified condition.
Under certain circumstances, if allowed by the provisions of the rental agreement, a rental
agreement may be ended when either party gives written notice to the other of their intention. Send
all correspondence relating to your intentions to the landlord by certified mail or deliver it by hand
and insist on a receipt.
Florida Statutes provides that a service member may terminate his or her rental agreement under
certain conditions.
It is usually a good idea to talk with the landlord in person, too. If you must cancel a lease before its
expiration date, perhaps the landlord will accept the security deposit as the total financial obligation.
If so, be sure to obtain a signed agreement to this effect from the landlord.
When you move from a rental unit – no matter the duration – be sure to settle all accounts.
Terminate utility service the day you leave, notify the landlord, post office and others your address
change and make other arrangements to minimize inconvenience to the landlord or the new tenants.
One of the most important responsibilities as a tenant is to leave the premises in a clean condition
for the next occupant. Be sure to vacuum, sweep, and clean all rooms, cabinets and appliances, as
well as other areas specified in the terms and conditions of the rental agreement.
Take a last walk-through with the landlord. Note any damages in writing and reach a final
agreement.
2011 – Tenant Rights
QUICK REFERENCE GUIDE
TO COMPLETE FORMS
Notice from Tenant to Landlord – Withhold Rent [Form #1] -
Print the name, address and telephone number of the landlord(s).
Read each line and select and/or fill in the appropriate response.
Date and sign in the space provided and print your name, address and telephone number.
A tenant cannot withhold rent from the landlord without sending the above notice and allowing
the landlord time to make repairs. If the repairs are not made, the tenant may withhold rent. In
any legal proceeding, however, the tenant will have to pay all past due rent, and rent as it comes
due during the legal proceedings, into the registry of the court. The tenant should, therefore,
deposit all rent as it comes due in a separate bank account until the tenant's disputes with the
landlord have been resolved.
Notice from Tenant to Landlord – Termination of Lease [Form #2] -
Print the name, address and telephone number of the landlord(s).
Read each line and select and/or fill in the appropriate response.
Date and sign in the space provided and print your name, address and telephone number.
The tenant should carefully review section 83.51(1), Florida Statutes, and the lease and should
ensure that the violations in the notice do, in fact, exist. The tenant's right to terminate the lease
exists only after notice is given and if the landlord fails to make the required repairs. Section
83.51 F.S. provides as follows:
83.51 Landlord's obligation to maintain premises.
(1) The landlord at all times during the tenancy shall:
(a) Comply with the requirements of applicable building, housing, and health codes; or
(b) Where there are no applicable building, housing, or health codes, maintain the roofs,
windows, screens, doors, floors, steps, porches, exterior walls, foundations, and all other
structural components in good repair and capable of resisting normal forces and loads and the
plumbing in reasonable working condition. However, the landlord shall not be required to
maintain a mobile home or other structure owned by the tenant.
The landlord's obligations under this subsection may be modified by the lease in the case of a
single-family home or duplex.
Motion to Determine Amount of Rent [Form #3] -
Fill in the reference number and names of Plaintiff(s) and Defendant(s).
Read each line and select and/or fill in the appropriate response.
Date and sign in the space provided and print your name, address and telephone number.
If you and the landlord do not agree on the amount of rent owed, give the Clerk of the Court the
money you say you owe. You must also file the above mentioned motion and the judge will
decide what amount should be given to the Clerk of the Court by way of a hearing and/or an order.
Form 1- Tenant Rights Packet (Form 4 - FL Bar Forms)
FORM 1
NOTICE FROM TENANT TO LANDLORD--WITHHOLDING RENT FOR
FAILURE OF LANDLORD TO MAINTAIN PREMISES AS REQUIRED BY FLORIDA
STATUTE 83.51(1) OR MATERIAL PROVISIONS OF THE RENTAL AGREEMENT
INSTRUCTIONS
A Tenant cannot withhold rent from the Landlord without sending notice and allowing the Landlord time to cure the
non-compliance, violation, or default of its ob ligations. Failure to send the required notice to th e Landlord has
significant impact on a Tenant’s rights under the rental agreement and Florida Statutes. If the non-compliance is not
remedied within the time period specified by statute (or such longer time as may be granted in your written rental
agreement) and the Landlord’s failure to comply renders the dwelling unit untenantable and the Tenant vacates, the
Tenant may vacate and withhold all rent, or, if the failure to comply does not render the dwelling unit untenantable,
rent may be reduce d in proportion to the loss of rental value caused by the non-compliance. If t he Landlord’s
violation of its obligations is not remedied, but the failure to cure the non-compliance does not render the dwelling
unit untenantable, the Tenant may remain in the dwelling unit and the rent shall be reduced, until the violation is
cured, by an amount in proportion to the loss of rental value caused by the failure to cure the violation. In any legal
proceeding, however, the Tenant will have to pay all p ast due rent, and rent as it co mes due during the legal
proceedings, into the registry of t he Court. The Tenant should, therefore, deposit all rent as i t comes due i n a
separate bank account until the Tenant's disputes with the Landlord have been resolved. For t he text of Fl orida
Statute 83.51(1), and the grounds for withholding rent, see the note to Form 3.
SOURCE: Sections 83.56 and 83.60, Florida Statutes (2007).
FORM NOTES ARE FOR I NFORMATIONAL PURPOSES ONLY AND MAY NOT COMPLETELY
DESCRIBE REQUIREMENTS OF FLORIDA LAW. YOU S HOULD CONSULT AN ATTORNEY AS
NEEDED.
Form 1 Tenant Rights Packet (Form 4 - FL Bar Forms)
NOTICE FROM TENANT TO LANDLORD--WITHHOLDING RENT FOR
FAILURE
OF LANDLORD TO MAINTAIN PREMISES AS REQUIRED BY FLORIDA
STATUTE 83.51(1) OR MATERIAL PROVISIONS OF THE RENTAL AGREEMENT
To:
Landlord’s Name
Address
City, State, Zip Code
From:
Date:
Tenant
This is to inform you that you are not maintaining my dwelling unit as required by Florida Statute 83.51(1)
or material provisions of our rental agreement. I f you do not complete the following repairs, non-compliance,
violation or default, within seven days I i ntend to withhold future rental payment and/or terminate the rental
agreement:
[list non-compliance violations or default]
This letter is sent to you pursuant to Florida Statute 83.56.
_______________________________________
Tenant’s Name __________________________
Address, Unit Number ____________________
_______________________________________
Phone Number __________________________
Approved for use under rule 10-2.1(a) of
the Rules Regulating The Florida Bar
The Florida Bar 2010
This form was completed
with the assistance of:
Name:
Address:
Telephone Number:
Form 2 - Tenant Rights Packet (FL Bar Form 3)
FORM 2
NOTICE FROM TENANT TO LANDLORD--TERMINATION FOR
FAILURE OF LANDLORD TO MAINTAIN PREMISES AS REQUIRED
BY FLORIDA STATUTE 83.51(1) OR MATERIAL PROVISIONS
OF THE RENTAL AGREEMENT
INSTRUCTIONS
Tenant should carefully review Sections 83.51(1) and 83.51(2) Florida Statutes and the rental agreement and should
ensure that the violations by the Landlord alleged by the Tenant in the notice do, in fact, exist. The Tenant's right to
terminate the rental agreement exists only after giving the notice and if the Landlord materially fails to maintain the
premises as required by section 83.51 or material provision of the rental agreement. Section 83.51(1) provides as
follows:
83.51 Landlord's obligation to maintain premises.
(1) The Landlord at all times during the tenancy shall:
(a) Comply with the requirements of applicable building, housing, and health codes; or
(b) Where there are no a pplicable building, housing, or health codes, maintain the roofs,
windows, screens, doors, floors, steps, porches, exterior walls, foundations, and all other
structural components in good repair and capable of resisting normal forces and loads and
the plumbing in reasonable working condition. However, the Landlord shall not be
required to maintain a mobile home or other structure owned by the Tenant.
The Landlord's obligations under this subsection may be modified by the lease in the case of a
single-family home or duplex.
(2) (a) Unless otherwise agreed in writing, in additio n to the requirements of subsection (1), the
landlord of a dwelling unit other than a sin gle-family home or duplex shall, at all times
during the tenancy, make reasonable provisions for:
1. The extermination of rats, mice, roaches, ants, wood-destroying organisms, and bedbugs.
When vacation of the prem ises is required for such extermination, the landl ord shall not
be liable for damages but shall abate the rent. The tenant shall be required to temporarily
vacate the premises for a period of time not to exceed 4 days, on 7 days' written notice, if
necessary, for extermination pursuant to this subparagraph.
2. Locks and keys.
3. The clean and safe condition of common areas.
4. Garbage removal and outside receptacles therefor.
5. Functioning facilities for heat during winter, running water, and hot water.
(b) Unless otherwise agreed in writing, at the commencement of the tenancy of a single-family
home or duplex, the landlord shall install working smoke detection devices. As used in this
paragraph, the term "smoke detection device" means an electrical or battery-operated
device which detects visible or invisible particles of combustion and which is listed by
Form 2 - Tenant Rights Packet (FL Bar Form 3)
Underwriters Laboratories, Inc., Factory Mutual Laboratories, Inc., or any other nationally
recognized testing laboratory using nationally accepted testing standards.
(c) Nothing in this part authorizes the tenant to raise a noncompliance by the landlord with this
subsection as a defense to an action for possession under s. 83.59.
(d) This subsection shall not apply to a mobile home owned by a tenant.
(e) Nothing contained in this subsection prohibits the landlord from providing in the rental
agreement that the tenant is obligated to pay costs or charges for garbage removal, water,
fuel, or utilities.
(3) If the duty imposed by subsection (1) is the same or greater than any duty imposed by
subsection (2), the landlord's duty is determined by subsection (1).
(4) The landlord is not responsible to the tenant under this section for conditions created or caused
by the negligent or wrongful act or omission of the tenant, a member of the tenant's family, or
other person on the premises with the tenant's consent.
SOURCE: Section 83.56, Florida Statutes (2007).
FORM NOTES ARE FOR I NFORMATIONAL PURPOSES ONLY AND MAY NOT COMPLETELY
DESCRIBE REQUIREMENTS OF FLORIDA LAW. YOU S HOULD CONSULT AN ATTORNEY AS
NEEDED.
Form 2 - Tenant Rights Packet (FL Bar Form 3)
NOTICE FROM TENANT TO LANDLORD--TERMINATION FOR
FAILURE
OF LANDLORD TO MAINTAIN PREMISES AS REQUIRED
BY FLORIDA STATUTE 83.51(1) OR MATERIAL PROVISIONS
OF THE RENTAL AGREEMENT
To:
Landlord’s Name (or La ndlord’s authorized
representative, resident manager, or the person
who collects the rent from the Landlord)
Address
City, State, Zip Code
From:
Date:
Re:
Seven Day Notice of Noncompliance to
Landlord
This is to inform you that you are not maintaining my dwelling unit as required by Florida Statute 83.51(1)
and our rental agreement. If you do not complete the following repairs, non-compliance, violations, or default in the
next seven days, I intend to terminate the rental agreement, move out, and hold you responsible for any damages
resulting from the termination:
[list Landlord's violations, non-compliance, or default]
_______________________________________
Tenant’s Name __________________________
Address, Unit Number_____________________
_______________________________________
Phone Number __________________________
Approved for use under rule 10-2.1(a) of
the Rules Regulating The Florida Bar
The Florida Bar 2010
This form was completed
with the assistance of:
Name:
Address:
Telephone Number:
2011 – Tenant Rights Form #3
IN THE COUNTY COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
Reference No: ______________________
___________________________
Plaintiff(s)
vs.
___________________________
Defendant(s)
MOTION TO DETERMINE AMOUNT OF RENT TO
DEPOSIT INTO REGISTRY OF COURT
Pursuant to F.S. 83.60(2), Defendant(s) hereby request the Court to determine the amount
of rent to be deposited in the Registry of Court.
1. Defendant(s) believe that the amount of rent claimed in the Complaint or Notice of Termination
is incorrect for the following reason(s):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
2. The documents which support the Defendant(s) position are as follows and copies are attached
herewith:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
I certify that a copy of this document was [√ one only] mailed faxed and mailed
hand delivered to the person(s) listed below on the _____ day of ______________, 20______.
Date: __________________
Signature of Defendant(s)
Print Name:
Address:
City, State, Zip:
Telephone No:
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Ken BurKe, C.P.A. www.mypinellasclerk.org (Pinellas County Clerk of the Circuit Court and Comptroller)

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Completed 10 February 2021

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