Form DFS-N1-2002 "Notice of Change in Location of Cinerator Facility" - Florida

What Is Form DFS-N1-2002?

This is a legal form that was released by the Florida Department of Financial 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 July 1, 2012;
  • The latest edition provided by the Florida Department of Financial 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 printable version of Form DFS-N1-2002 by clicking the link below or browse more documents and templates provided by the Florida Department of Financial Services.

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Download Form DFS-N1-2002 "Notice of Change in Location of Cinerator Facility" - Florida

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DEPARTMENT OF FINANCIAL SERVICES
Division of Funeral, Cemetery & Consumer Services
200 East Gaines Street
Tallahassee, FL 32399- 0361
Notice of Change in Location of Cinerator Facility
This form is used to report a change in location of a Cinerator Facility, and to request an inspection of the
proposed new location, pursuant to s. 497.606(7), Florida Statutes. Operations at the new location may NOT
start until an inspection of the new location by the Division of Funeral, Cemetery, and Consumer Services
(Division) is conducted and passed. This form is NOT used to report a change in ownership of a Cinerator
Facility. This form should be filed BEFORE the new location is ready for inspection, because the Division
will need some lead time to schedule the inspection. This form requires payment of a $25 new license card
fee (to show new address) and $225 inspection fee.
Fill out, sign, and mail this form, with your check in the amount of $250, payable to “Dept. of Financial
Services,” to:
Department of Financial Services
Revenue Processing Section
P O Box 6100
Tallahassee, FL 32314-6100
1) Name of Cinerator Facility as shown on license:
2) License # of Cinerator Facility:
3) Current address (street, city, state, zip):
4) Proposed new address (street, city, state, zip):
5) Date the new location will be ready for inspection:
6) Name of Cinerator Facility’s contact person:
7) Phone number of person name above: (
)
-
______________________________________
______________
Signature of Cinerator Facility representative
Date signed
Questions? Call Division staffer Jasmin Richardson at (850) 413-3039
DFS RECEIPTS SECTION
BT
TYCL FT
V
2900
E
$225
3801
F
$ 25
Form DFS-N1-2002
Rev 7/2012, Rule 69K-1.001, F.A.C.
DEPARTMENT OF FINANCIAL SERVICES
Division of Funeral, Cemetery & Consumer Services
200 East Gaines Street
Tallahassee, FL 32399- 0361
Notice of Change in Location of Cinerator Facility
This form is used to report a change in location of a Cinerator Facility, and to request an inspection of the
proposed new location, pursuant to s. 497.606(7), Florida Statutes. Operations at the new location may NOT
start until an inspection of the new location by the Division of Funeral, Cemetery, and Consumer Services
(Division) is conducted and passed. This form is NOT used to report a change in ownership of a Cinerator
Facility. This form should be filed BEFORE the new location is ready for inspection, because the Division
will need some lead time to schedule the inspection. This form requires payment of a $25 new license card
fee (to show new address) and $225 inspection fee.
Fill out, sign, and mail this form, with your check in the amount of $250, payable to “Dept. of Financial
Services,” to:
Department of Financial Services
Revenue Processing Section
P O Box 6100
Tallahassee, FL 32314-6100
1) Name of Cinerator Facility as shown on license:
2) License # of Cinerator Facility:
3) Current address (street, city, state, zip):
4) Proposed new address (street, city, state, zip):
5) Date the new location will be ready for inspection:
6) Name of Cinerator Facility’s contact person:
7) Phone number of person name above: (
)
-
______________________________________
______________
Signature of Cinerator Facility representative
Date signed
Questions? Call Division staffer Jasmin Richardson at (850) 413-3039
DFS RECEIPTS SECTION
BT
TYCL FT
V
2900
E
$225
3801
F
$ 25
Form DFS-N1-2002
Rev 7/2012, Rule 69K-1.001, F.A.C.