Form FDACS-03585 "Lp Gas Material Change and Duplicate Licenses Form" - Florida

Form FDACS-03585 or the "Lp Gas Material Change And Duplicate Licenses Form" is a form issued by the Florida Department of Agriculture and Consumer Services.

The form was last revised in August 1, 2018 and is available for digital filing. Download an up-to-date fillable Form FDACS-03585 in PDF-format down below or look it up on the Florida Department of Agriculture and Consumer Services Forms website.

ADVERTISEMENT

Download Form FDACS-03585 "Lp Gas Material Change and Duplicate Licenses Form" - Florida

294 times
Rate
(4.4 / 5) 15 votes
Florida Department of Agriculture and Consumer Services
Division of Consumer Services
Submit and Pay Online at:
www.FreshFromFlorida.com
LP GAS MATERIAL CHANGE
- or -
AND DUPLICATE LICENSES FORM
Check or Money Order payable to
FDACS and remit with form to:
Sections 527.02(4), Florida Statutes
ADAM H. PUTNAM
FDACS
COMMISSIONER
PO Box 6700
Tallahassee, FL 32314-6700
Pursuant to section 527.02(4), F.S., any licensee submitting a material change in their information for licensing, before the date
for renewal, must submit such change to the department, along with a $10 fee. Enclose a check or money order in the amount
of $10 made payable to FDACS. All fees are non-refundable.
Select One:
Supplier Change
Address Change
Duplicate Company License
Request for Duplicate Certification/Qualification
Qualifier/Master Qualifier Position Location Transfer Request
Name/Business Name
:
License/Qualifier Number
:
(as listed with the department)
(as issued by the department)
Prior Information:
Revised Information:
F&A Use Only
Org Code: 42 10 06 25 000
EO: A2
Object Code: 001215
$10.00
FDACS-03585 08/18
Florida Department of Agriculture and Consumer Services
Division of Consumer Services
Submit and Pay Online at:
www.FreshFromFlorida.com
LP GAS MATERIAL CHANGE
- or -
AND DUPLICATE LICENSES FORM
Check or Money Order payable to
FDACS and remit with form to:
Sections 527.02(4), Florida Statutes
ADAM H. PUTNAM
FDACS
COMMISSIONER
PO Box 6700
Tallahassee, FL 32314-6700
Pursuant to section 527.02(4), F.S., any licensee submitting a material change in their information for licensing, before the date
for renewal, must submit such change to the department, along with a $10 fee. Enclose a check or money order in the amount
of $10 made payable to FDACS. All fees are non-refundable.
Select One:
Supplier Change
Address Change
Duplicate Company License
Request for Duplicate Certification/Qualification
Qualifier/Master Qualifier Position Location Transfer Request
Name/Business Name
:
License/Qualifier Number
:
(as listed with the department)
(as issued by the department)
Prior Information:
Revised Information:
F&A Use Only
Org Code: 42 10 06 25 000
EO: A2
Object Code: 001215
$10.00
FDACS-03585 08/18
ADVERTISEMENT
Fill PDF online