"Employee's Badge List" - Florida

This fillable "Employee's Badge List" is a document issued by the Florida Department of Agriculture and Consumer Services specifically for Florida residents.

Download the PDF by clicking the link below and complete it directly in your browser or through the Adobe Desktop application.

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Download "Employee's Badge List" - Florida

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EMPLOYEE’S BADGE LIST
 
Date: ________________________________ Employer: ______________________________________
You are requested to list hereunder the names of all persons who will be employed by you while you are
racing in the State of Delaware.
STABLE: ____________________________ TRAINER: _____________________________________
Date Added to List:
DHRC License No:
Name of Employee:
Date Deleted from List:
1. _______________________________________________________________________________
2. _______________________________________________________________________________
3. _______________________________________________________________________________
4. _______________________________________________________________________________
5. _______________________________________________________________________________
6. _______________________________________________________________________________
7. _______________________________________________________________________________
8. _______________________________________________________________________________
9. _______________________________________________________________________________
10. _______________________________________________________________________________
11. _______________________________________________________________________________
12. _______________________________________________________________________________
13. _______________________________________________________________________________
14. _______________________________________________________________________________
15. _______________________________________________________________________________
Telephone Number: __________________________
Signature: ________________________________
INSURANCE COMPANY: _______________________________________________________________
Policy No: _________________________________
Expiration Date: ____________________________
***IMPORTANT: ALL GROOMS must have a CURRENT Delaware Harness Racing Commission License.
EMPLOYEE’S BADGE LIST
 
Date: ________________________________ Employer: ______________________________________
You are requested to list hereunder the names of all persons who will be employed by you while you are
racing in the State of Delaware.
STABLE: ____________________________ TRAINER: _____________________________________
Date Added to List:
DHRC License No:
Name of Employee:
Date Deleted from List:
1. _______________________________________________________________________________
2. _______________________________________________________________________________
3. _______________________________________________________________________________
4. _______________________________________________________________________________
5. _______________________________________________________________________________
6. _______________________________________________________________________________
7. _______________________________________________________________________________
8. _______________________________________________________________________________
9. _______________________________________________________________________________
10. _______________________________________________________________________________
11. _______________________________________________________________________________
12. _______________________________________________________________________________
13. _______________________________________________________________________________
14. _______________________________________________________________________________
15. _______________________________________________________________________________
Telephone Number: __________________________
Signature: ________________________________
INSURANCE COMPANY: _______________________________________________________________
Policy No: _________________________________
Expiration Date: ____________________________
***IMPORTANT: ALL GROOMS must have a CURRENT Delaware Harness Racing Commission License.
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