Charlotte County, Florida - Clerk of the Court

APPLICATION FOR HOME SOLICITATION
SALE PERMIT

INSTRUCTIONS

1. All applicants must appear in person.

2. The cost of this application is $55.00, payable in U.S. currency, certified check, cashier's check or money order, which is non-refundable, to Barbara T. Scott, Clerk of the Circuit Court.

3. Upon payment of the above fee the applicant shall complete the application form, according to F.S. 501.022(2). Be sure all addresses are complete with city, state and zip code. Each and every line must be completed and sworn to before a deputy clerk.

4. When your application has been completed, you will be given a fingerprint card by the deputy clerk and a copy of your application which you must take to the Sheriff's Department, located at 7474 Utilities Road, Punta Gorda, Florida 33982.

5. Once the Sheriff's Department returns the fingerprint card to the Clerk's Office we will forward it to the Department of Law Enforcement in Tallahassee for fingerprint analysis. The Sheriff's Department and the Department of Law Enforcement have sixty (60) days in which to return the results of the fingerprint analysis to this office.

6. When the Clerk's Office receives the results of the name search and fingerprint analysis, you will be notified by telephone or U.S. Mail. You must then come to our office in person to sign for and receive your permit.

APPLICATIONS MAY BE OBTAINED MONDAY THROUGH FRIDAY, FROM 8:00 A.M. UNTIL 5:00 P.M. AT THE PUNTA GORDA OFFICE.

Date:

Florida Department of Law Enforcement
Special Services Bureau
Criminal Record Inquiry Section
P.O. Box 1489
Tallahassee, FL 32302

Pursuant to provisions of Chapter 119, Florida Statutes, and procedures outlined under Rule Chapter 11C-6, F.A.C., attached are ______________ applicant fingerprint card(s) on subjects for which we are seeking a criminal history record check. Our Account Code Number is FL008015J.

It is requested that the processing fee per applicant be billed monthly to the following office.

Twentieth Judicial Circuit Court
Attention: Patti Towne Director, Records and Recording
PO Box 510156
Punta Gorda, FL 33951-0156

Thank you for your time and cooperation.

Requested/Authorized by:

__________________________
(Name) (Title)

Sincerely,

BARBARA T. SCOTT
CLERK OF THE CIRCUIT COURT

By: Deputy Clerk

APPLICATION

HOME SOLICITORS PERMIT

Charlotte County, Florida Permit #

1. NAME: SS#

________________________________________________________________

Last First Middle

2. PERMANENT RESIDENCE ADDRESS:

________________________________________________________________

Number & Street

________________________________________________________________

City County State Zip

TELEPHONE: ( ) ( )

____________________________ _______________________________

Home Business

3. LOCAL RESIDENCE ADDRESS:

________________________________________________________________

Number & Street

________________________________________________________________

City County State Zip

4. DATE OF BIRTH: / / 5. PLACE OF BIRTH: mo day yr City & State

6. RACE: 7. SEX: 8. MARITAL STATUS:

9. EMPLOYER'S NAME:

________________________________________________________________

ADDRESS:

________________________________________________________________

Number & Street

________________________________________________________________

City State Zip

10. I HAVE REQUIRED CURRENT COUNTY OR MUNICIPAL OCCUPATIONAL LICENSES. YES NO

11. HAVE YOU EVER BEEN CONVICTED OF, PLEADED GUILTY OR NOLO CONTENDERE TO ANY CRIME? YES NO

If yes, state the nature of the offense; place of offense; punishment or penalty assessed therefore:

I UNDERSTAND THAT THIS PERMIT CAN OR WILL BE REVOKED IF I AM CONVICTED OF, PLEAD GUILTY OR NOLO CONTENDERE TO ANY CRIME IN ANY JURISDICTION.

I DO SOLEMNLY SWEAR THAT ALL OF THE ABOVE IS TRUE AND CORRECT.

Applicant's Signature

STATE OF FLORIDA

COUNTY OF CHARLOTTE

Sworn and subscribed to before me this day of 19 .

BARBARA T. SCOTT

Clerk of the Circuit Court

By:

Deputy Clerk