Get And Sign STATE OF FLORIDA DISBURSEMENT UNIT Hillsclerk 2003-2021 Form

Is personally known or has provided as identification. Date Notary Public Area Code Home Phone Area Code Work Phone My commission expires Rev 9/2003. Enter information for ONE CHECK only. A COMPLETED SIGNED and NOTARIZED AFFIDAVIT MUST BE COMPLETED FOR EACH LOST STOLEN or STALE-DATED CHECK. I understand that if I receive the missing check at any time during this process and I deposit or cash the check then I will be held liable for the refund of the check and any fees assessed. In addition I...