Form FDACS-10063 "Board of Professional Surveyors and Mappers Post Examination Review Request" - Florida

What Is Form FDACS-10063?

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, 2012;
  • 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-10063 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-10063 "Board of Professional Surveyors and Mappers Post Examination Review Request" - Florida

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Florida Department of Agriculture and Consumer Services
Division of Consumer Services
Remit Payment Online at:
www.FDACS.gov
BOARD OF PROFESSIONAL
- or -
SURVEYORS AND MAPPERS
Check or Money Order
payable to FDACS and remit
POST EXAMINATION REVIEW REQUEST
with request to:
Chapter 472, Florida Statutes
NICOLE "NIKKI" FRIED
FDACS
Rule 5J-17.036(2), Florida Administrative Code
P.O. Box 6700
COMMIS SIONER
1-800-HELP-FLA (435-7352) • 850-410-3800
Tallahassee, FL 32314-6700
www.FDACS.gov • 850-410-3804 Fax
If you wish to request a review of your examination, complete this form and enclose the $75 fee. This request must be
received within twenty-one (21) days of the mailing date of the original grade notice. ANY REQUEST RECEIVED PAST
THE TWENTY-ONE (21) DAY DEADLINE WILL NOT BE PROCESSED.
CANDIDATE INFORMATION
Name
Social Security Number
**
Mailing Address
Examination Date
City, State, Zip Code
Part(s) Failed
Telephone, including Area Code
Candidate Number
 English
 ADA/Special
Alternate Telephone, including Area Code
Email Address
EXAMINATION REVIEW
Review sessions will be held in Orlando and Tallahassee, Florida. However, all requests must be mailed to the
address listed above. You will be notified, in writing, of the exact date, time and location of the review.
REQUESTS: A review of the national exams (Fundamentals and Principles and Practice) is prohibited.
 Florida Multiple Choice
Please Indicate Site Preference:
 Orlando
 Tallahassee
Org Code: 42100801000
** Under the Federal Privacy Act, disclosure of Social Security Numbers is voluntary,
EO: A2
unless specifically required by federal statute. Social Security numbers must be
Object Code: 001253
$75
recorded on all professional license applications and will be used for licensee
identification pursuant to the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, 104 Pub.L. 193, Sec 317. Social Security numbers will be
used to allow efficient screening of applicants and licensees by a Title IV-D child
support agency to assure compliance with child support obligations. As such,
disclosure of your Social Security number is required on this application under Sections
409.2577, 409.2598, and 472. 015, Florida Statutes. Social Security numbers are not
a public record under Florida law.
FDACS-10063 Rev. 02/12
Florida Department of Agriculture and Consumer Services
Division of Consumer Services
Remit Payment Online at:
www.FDACS.gov
BOARD OF PROFESSIONAL
- or -
SURVEYORS AND MAPPERS
Check or Money Order
payable to FDACS and remit
POST EXAMINATION REVIEW REQUEST
with request to:
Chapter 472, Florida Statutes
NICOLE "NIKKI" FRIED
FDACS
Rule 5J-17.036(2), Florida Administrative Code
P.O. Box 6700
COMMIS SIONER
1-800-HELP-FLA (435-7352) • 850-410-3800
Tallahassee, FL 32314-6700
www.FDACS.gov • 850-410-3804 Fax
If you wish to request a review of your examination, complete this form and enclose the $75 fee. This request must be
received within twenty-one (21) days of the mailing date of the original grade notice. ANY REQUEST RECEIVED PAST
THE TWENTY-ONE (21) DAY DEADLINE WILL NOT BE PROCESSED.
CANDIDATE INFORMATION
Name
Social Security Number
**
Mailing Address
Examination Date
City, State, Zip Code
Part(s) Failed
Telephone, including Area Code
Candidate Number
 English
 ADA/Special
Alternate Telephone, including Area Code
Email Address
EXAMINATION REVIEW
Review sessions will be held in Orlando and Tallahassee, Florida. However, all requests must be mailed to the
address listed above. You will be notified, in writing, of the exact date, time and location of the review.
REQUESTS: A review of the national exams (Fundamentals and Principles and Practice) is prohibited.
 Florida Multiple Choice
Please Indicate Site Preference:
 Orlando
 Tallahassee
Org Code: 42100801000
** Under the Federal Privacy Act, disclosure of Social Security Numbers is voluntary,
EO: A2
unless specifically required by federal statute. Social Security numbers must be
Object Code: 001253
$75
recorded on all professional license applications and will be used for licensee
identification pursuant to the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, 104 Pub.L. 193, Sec 317. Social Security numbers will be
used to allow efficient screening of applicants and licensees by a Title IV-D child
support agency to assure compliance with child support obligations. As such,
disclosure of your Social Security number is required on this application under Sections
409.2577, 409.2598, and 472. 015, Florida Statutes. Social Security numbers are not
a public record under Florida law.
FDACS-10063 Rev. 02/12