Form Dr-418e - Enterprise Zone Ad Valorem Property Tax Exemption Child Care Facility Application For Exemption Certification
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2DR-418E
ENTERPRISE ZONE AD VALOREM PROPERTY TAX EXEMPTION
N. 12/99
CHILD CARE FACILITY
A
PPLICATION FOR EXEMPTION CERTIFICATION
Section 196.095, Florida Statutes
To be filed with the board of commissioners of the enterprise zone development agency for the enterprise zone
in which the child care facility is located by February I (suggested date - see instructions) of the year for which
exemption is claimed.
PART 1. COMPLETED BY APPLICANT
Date you purchased this location
Business
name
Date you began business at this facility
Mailing
Date the facility was licensed
address
(Department of Children and Family Services or
local licensing authority under s. 402.308, F.S.)
A copy of the current license must be attached to this application:
Owner or person in charge
Phone
Exact location (legal description and street address) of property for which this application is filed
I do hereby certify that the above facility is owned by the person listed above and is used as a child care
facility as defined in s. 402.302, F.S. Further, I declare under penalties of perjury that I have read the
foregoing application for exemption and all information above and any attachments to this application are true
and correct as of January 1 of this year.
Signature
Title
Date
PART 2. COMPLETED BY ENTERPRISE ZONE DEVELOPMENT AGENCY, CERTIFICATION
Agency
Address
name
Phone
We hereby certify that the child care facility listed above is located and operates in Enterprise Zone
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, as designated by the Florida Department of Commerce; a copy of the current
license issued by the Florida Department of Children and Family Services or local licensing authority was
attached to this application; and, therefore, this child care facility meets the eligibility criteria established
under section 196.095, F.S.
Signature
Title
Date
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