Exemption Fraud Form

NOTICE! Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public-records request, omit this information when you complete the form, or do not send electronic mail to this entity. Instead, contact this office by phone or in writing. If you wish to remain anonymous, do not add your name, phone number or email address.


Address of property you believe is receiving an improper exemption: Property is (Please check all that apply):


Name of Property Owner, if known:
Please explain in detail why you believe this property is receiving an improper exemption:
If we need additional information, may we contact you?
If yes, please provide your Name and Daytime phone Number or Email Address:
Name:
Day Time Phone Number:
Email Address:
 

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201 Howell Avenue, Suite 300, Brooksville, Fl 34601-2042
Phone (352) 754-4190
Fax (352) 754-4198


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