Form DBPR-LO1 "Labor Organization Application/ Annual Report" - Florida

What Is Form DBPR-LO1?

This is a legal form that was released by the Florida Department of Business & Professional Regulation - 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 December 1, 2016;
  • The latest edition provided by the Florida Department of Business & Professional Regulation;
  • 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 printable version of Form DBPR-LO1 by clicking the link below or browse more documents and templates provided by the Florida Department of Business & Professional Regulation.

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Download Form DBPR-LO1 "Labor Organization Application/ Annual Report" - Florida

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STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
LABOR ORGANIZATION APPLICATION/
ANNUAL REPORT
DBPR – LO 1
If you have any questions or need assistance in completing this application, please contact the
Department of Business and Professional Regulation, Customer Contact Center, at (850) 487-1395.
Please send your completed application, documentation and required fee to:
Department of Business and Professional Regulation
2601 Blair Stone Road
Tallahassee, FL 32399-0783
CHECK TRANSACTION REQUESTED
Transaction Type:
□ Initial Application – $1.00 fee
□ Renewal – $1.00 fee
License #LO
ORGANIZATION INFORMATION
Name of Labor Organization
Federal Employer Identification Number
MAILING ADDRESS
Street Address or P.O. Box
City
State
Zip Code (+4 optional)
County (if Florida address)
Country
BUSINESS LOCATION ADDRESS
Street Address
City
State
Zip Code (+4 optional)
County (if Florida address)
Country
CONTACT INFORMATION
Business Phone Number
Primary E-Mail Address
ADDITIONAL ORGANIZATION INFORMATION
Number of Members
Date Established
Union Local Number
Florida entity recognizing this organization
(if seeking to represent private employees)
Date of registration with the Public Employees Relations Commission
(if seeking to represent public employees)
Rev. 12/2016
1
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
LABOR ORGANIZATION APPLICATION/
ANNUAL REPORT
DBPR – LO 1
If you have any questions or need assistance in completing this application, please contact the
Department of Business and Professional Regulation, Customer Contact Center, at (850) 487-1395.
Please send your completed application, documentation and required fee to:
Department of Business and Professional Regulation
2601 Blair Stone Road
Tallahassee, FL 32399-0783
CHECK TRANSACTION REQUESTED
Transaction Type:
□ Initial Application – $1.00 fee
□ Renewal – $1.00 fee
License #LO
ORGANIZATION INFORMATION
Name of Labor Organization
Federal Employer Identification Number
MAILING ADDRESS
Street Address or P.O. Box
City
State
Zip Code (+4 optional)
County (if Florida address)
Country
BUSINESS LOCATION ADDRESS
Street Address
City
State
Zip Code (+4 optional)
County (if Florida address)
Country
CONTACT INFORMATION
Business Phone Number
Primary E-Mail Address
ADDITIONAL ORGANIZATION INFORMATION
Number of Members
Date Established
Union Local Number
Florida entity recognizing this organization
(if seeking to represent private employees)
Date of registration with the Public Employees Relations Commission
(if seeking to represent public employees)
Rev. 12/2016
1
DBPR LO 1 – Labor Organization Application/Annual Report
Please provide information on the current officers.
PRESIDENT
Last Name
First
Middle
Title
Suffix
Residential Street Address
City
State
Zip Code (+4 optional)
SECRETARY
Last Name
First
Middle
Title
Suffix
Residential Street Address
City
State
Zip Code (+4 optional)
TREASURER
Last Name
First
Middle
Title
Suffix
Residential Street Address
City
State
Zip Code (+4 optional)
BUSINESS AGENT
Last Name
First
Middle
Title
Suffix
Residential Street Address
City
State
Zip Code (+4 optional)
ATTEST STATEMENT
I have read the questions in this application and have answered them completely and truthfully to the best
of my knowledge.
I pledge to comply with the applicable standards of practice upon licensure, registration, or certification.
I understand the types of misconduct for which disciplinary proceedings may be initiated.
Giving knowingly misleading statements or knowing misrepresentation when applying for a license
constitutes a felony of the third degree and may result in licensure denial or revocation.
Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it
are true.
Secretary/Business Agent’s Name:
Secretary/Business Agent’s Signature:
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