Form FDACS-10211 "Sellers of Travel Independent Sales Agents Application" - Florida

What Is Form FDACS-10211?

This is a legal form that was released by the Florida Department of Agriculture and Consumer Services - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2017;
  • The latest edition provided by the Florida Department of Agriculture and Consumer Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form FDACS-10211 by clicking the link below or browse more documents and templates provided by the Florida Department of Agriculture and Consumer Services.

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Download Form FDACS-10211 "Sellers of Travel Independent Sales Agents Application" - Florida

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Florida Department of Agriculture and Consumer Services
Division of Consumer Services
Make check or money order payable
SELLERS OF TRAVEL
and remit with application to:
INDEPENDENT SALES AGENTS APPLICATION
FDACS
ADAM H. PUTNAM
P.O. Box 6700
COMMISSIONER
Sections 559.928(3), Florida Statutes
Tallahassee, FL 32399-6700
Rule 5J-9.002(2), Florida Administrative Code
1-800-HELP-FLA (435-7352) • (850) 410-3800 Calling Outside Florida
www.800helpfla.com • (850) 410-3804 Fax
An annual filing fee of $50 is required for each independent sales agent
PLEASE TYPE OR
(s. 559.928, F.S.).
PRINT. Additional pages may be attached if extra space is needed. All fees are non-refundable.
Name of person making statement:
,
First Name
Last Name
of
,
Title
Name operating under, if different than above
Located at:
in
,
Business Address of Independent Agent
City, State, Zip Code
in
,
Mailing Address of Independent Agent
City, State, Zip Code
Email Address
Business Telephone Number
Their Seller of
Seller of Travel you Represent
Their Address
Travel or ARC #
Additional pages may be attached if extra space is needed.
AND THEREFORE, I:
1.
Act for or on behalf of a seller of travel that is operating in compliance with Sections 559.926 - 559.939, Florida Statutes, the
Florida Sellers of Travel Act; AND
2.
Have a written contract with the seller(s) of travel listed above (please provide us a copy of the contract); AND
3.
Do not receive a fee, commission or other valuable consideration directly from the purchasers of travel or travel related services; AND
Do not at any time have any un-issued ticket stock in my possession; AND
4.
5.
Do not have the ability to issue tickets, lodging or vacation certificates, or any other travel documents.
Signature of Independent Sales Agent
Date
Org Code: 42 10 06 25 000
EO: A2
Object Code: 001115
$50.00
FDACS-10211 Rev. 02/17
Florida Department of Agriculture and Consumer Services
Division of Consumer Services
Make check or money order payable
SELLERS OF TRAVEL
and remit with application to:
INDEPENDENT SALES AGENTS APPLICATION
FDACS
ADAM H. PUTNAM
P.O. Box 6700
COMMISSIONER
Sections 559.928(3), Florida Statutes
Tallahassee, FL 32399-6700
Rule 5J-9.002(2), Florida Administrative Code
1-800-HELP-FLA (435-7352) • (850) 410-3800 Calling Outside Florida
www.800helpfla.com • (850) 410-3804 Fax
An annual filing fee of $50 is required for each independent sales agent
PLEASE TYPE OR
(s. 559.928, F.S.).
PRINT. Additional pages may be attached if extra space is needed. All fees are non-refundable.
Name of person making statement:
,
First Name
Last Name
of
,
Title
Name operating under, if different than above
Located at:
in
,
Business Address of Independent Agent
City, State, Zip Code
in
,
Mailing Address of Independent Agent
City, State, Zip Code
Email Address
Business Telephone Number
Their Seller of
Seller of Travel you Represent
Their Address
Travel or ARC #
Additional pages may be attached if extra space is needed.
AND THEREFORE, I:
1.
Act for or on behalf of a seller of travel that is operating in compliance with Sections 559.926 - 559.939, Florida Statutes, the
Florida Sellers of Travel Act; AND
2.
Have a written contract with the seller(s) of travel listed above (please provide us a copy of the contract); AND
3.
Do not receive a fee, commission or other valuable consideration directly from the purchasers of travel or travel related services; AND
Do not at any time have any un-issued ticket stock in my possession; AND
4.
5.
Do not have the ability to issue tickets, lodging or vacation certificates, or any other travel documents.
Signature of Independent Sales Agent
Date
Org Code: 42 10 06 25 000
EO: A2
Object Code: 001115
$50.00
FDACS-10211 Rev. 02/17