Number Assignment Request Form
Florida Master Site File
Division of Historical Resources / R.A. Gray Building
500 South Bronough St., Tallahassee, Florida 32399-0250
Phone 850.245.6440 / Fax 850.245.6439 / Email
SiteFile@dos.state.fl.us
Check for Previously Assigned Numbers (Required)
Yes, Florida Master Site File records were checked for previously recorded resources at this location.
(Checks typically involve address, name, or township, range & section searches, current GIS data checks or FMSFWeb searches)
Please indicate the method(s) used for checking: _________________________________________________
___________________________________________________________________ Date checked____________
Contact Information (Required)
_____________________________________________________________
Name:
______________________________________________
Organization (if applicable):
___________________________________________________________
Address:
__________________________________________________________________
___________________________
_____________________________
Phone:
Fax:
_____________________________________________________________
Email:
Project Name
(if applicable; use key words indicating location, tract name, survey phase, etc.)
____________________________________________________________________
____________________________________________________________________
Individual Request
(If more than 5 site numbers are needed use Block Request below)
County: ______________ Date of Request: ________ Date Assigned: ________ by FMSF Staff Person: ______
Select Resource Type:
□Archaeological
□Bridge
□Cemetery
□Structure
□Resource Group
Use a separate request form for each resource type (archaeology, structure, bridge, etc.), county, and project.
Site Name
Address or 1:24,000 Quad & Twnshp/Rng/Sect
Assigned Number
1 __________________________________________________________________
2 __________________________________________________________________
3 __________________________________________________________________
4 __________________________________________________________________
5 __________________________________________________________________
Block Request
(Use for a county where more than 5 assignments are needed)
County: ______________ Date of Request: ________ Date Assigned: ________ by FMSF Staff Person: ______
Archaeological Sites:_____ Bridges:_____ Cemeteries:_____ Structures:_____ Resource Groups:_____
Range of Numbers Assigned by the Florida Master Site File _________________________________________