PROFESSIONAL FUNDRAISING CONSULTANT,
PROFESSIONAL SOLICITOR OR
PROFESSIONAL SOLICITOR INDIVIDUAL
MATERIAL CHANGE FORM
1-800-HELP-FLA (435-7352) • (850) 410-3800 Calling Outside Florida
www.800helpfla.com • (850) 410-3804 Fax
Section 496.409(8), F.S., requires all licensed professional fundraising consultants to notify the Florida Department of
Agriculture and Consumer Services (FDACS) within 7 days of any material changes in information which was filed with the
department.
Section 496.410(13), F.S., requires all licensed professional solicitors to notify the Florida Department of Agriculture and
Consumer Services within 7 days of any material changes in information which was filed with the department.
Section 496.4101(5), F.S., requires all licensed professional solicitor individuals to notify the Florida Department of Agriculture
and Consumer Services within 10 days of any material changes in information which was submitted as a condition for license.
Name of Professional Fundraising Consultant/Professional Solicitor:
(as listed with the department)
License Number:
(issued by the department)
Prior Information:
Revised Information:
Signature
Date
Remit completed form to:
FDACS
Solicitation of Contributions
2005 Apalachee Pkwy.
Tallahassee, FL 32399-6500