Attachment 1 "Request for Advance Payment of Membership Dues in Proffessional or Other Organizations" - Florida

What Is Attachment 1?

This is a legal form that was released by the Florida Department of Juvenile Justice - 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 June 1, 2018;
  • The latest edition provided by the Florida Department of Juvenile Justice;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Attachment 1 by clicking the link below or browse more documents and templates provided by the Florida Department of Juvenile Justice.

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Download Attachment 1 "Request for Advance Payment of Membership Dues in Proffessional or Other Organizations" - Florida

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FLORIDA DEPARMTENT OF JUVENILE JUSTICE
FDJJ 1407.04
REQUEST FOR ADVANCE PAYMENT OF MEMBERSHIP
ATTACHMENT 1
DUES IN PROFFESSIONAL OR OTHER ORGANIZATIONS
REQUESTERS INFORMATION:
_______________________________
_______________________
________________
Requester
Org. Code
Expansion Option
_______________________________
________________________
________________
Street Address
Contact Person
Telephone Number
_______________________________
________________________
________________
City
State
Zip Code
ORGANIZATION INFORMATION:
_________________________________
_________________________
_________________
Name of Organization
Division/Program Office
Telephone Number
_________________________________
_______________________
________________
City
State
Zip Code
PRIOR FISCAL YEAR MEMBERSHIP INFORMATION:
_______________________________________
________________________________
Name/Title
Membership Type
________________________
________________________________
Amount
Period
CURRENT FISCAL YEAR MEMBERSHIP INFORMATION:
______________________________________
________________________________
Name/Title
Membership Type
________________________
________________________________
Amount
Period
1 |
P a g e
REVISED: 6/2018
FLORIDA DEPARMTENT OF JUVENILE JUSTICE
FDJJ 1407.04
REQUEST FOR ADVANCE PAYMENT OF MEMBERSHIP
ATTACHMENT 1
DUES IN PROFFESSIONAL OR OTHER ORGANIZATIONS
REQUESTERS INFORMATION:
_______________________________
_______________________
________________
Requester
Org. Code
Expansion Option
_______________________________
________________________
________________
Street Address
Contact Person
Telephone Number
_______________________________
________________________
________________
City
State
Zip Code
ORGANIZATION INFORMATION:
_________________________________
_________________________
_________________
Name of Organization
Division/Program Office
Telephone Number
_________________________________
_______________________
________________
City
State
Zip Code
PRIOR FISCAL YEAR MEMBERSHIP INFORMATION:
_______________________________________
________________________________
Name/Title
Membership Type
________________________
________________________________
Amount
Period
CURRENT FISCAL YEAR MEMBERSHIP INFORMATION:
______________________________________
________________________________
Name/Title
Membership Type
________________________
________________________________
Amount
Period
1 |
P a g e
REVISED: 6/2018
JUSTIFICATION AND BENEFITS TO THE STATE:
AUTHORIZATION:
______________________________________
________________________________
Agency Head or Authorized Designee
Date
REQUIRED ATTACHMENTS:
A. Requisition Number.
B. Notarized Vendor’s Certification of Availability of Records and that State Funds will not be used for
Lobbying as in accordance with Florida Statue, 119.012.
C. Non-Acceptance of Institutional Membership Statement, if required.
D. Quote from Vendor.
2 |
P a g e
REVISED: 6/2018
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