Personal Information
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Address Information
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Phone Number Information
FWC Identifier
Florida Statutes
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Attestation *
I hereby swear or affirm to the following: I have reviewed the appropriate section(s) of law listed above. I am an individual, or the parent/guardian of an individual, exempt pursuant to the public records exemption(s) indicated above. All information on this form is true and correct. Where applicable, I have made reasonable efforts to protect such information from being accessible through other means available to the public.