Registered Office & Agent Form- - -... - - S- PEC1 -XL DISTRICT REPORTING
Section L'09.--41110"'. Florida Statutes, requires that each special district in the state
designate a registered office and a registered agent and rile this information with
the Department of Community Affairs and the local governirng authority, Collier
County Board of County Commissioners. An.v changes in registered agent and
registered office must be report.ed to the above named agencies.
In the space below, please provide the coLT -ct name and address of your current
registered agent:
DISTRICT NIA fE- North Naples Fire Control & Rescue District
REGISTERED AGENT: Fire Chief g!,rb r C', '�<' '
f
P.EGISTERED OFFICE-: 1885 Veterans Park Drive
Naples FL '4109
In addition, please provide the telephone number of your registered agent:
PI-iON-E NUMBER.-
?-39) 597 -3???
Indicate your district's status (dependent or independent_) by marking- and X in the
appropriate space- (See section t'9.403, Florida Statutes, for definitions)
DEPENDENT
INDEPENDENT X
If the actual location of your special district office is different from that of your
registered agent, provide the district's business address in the space below-:
Please return this form, to the address below-:
Derek fohnssen, General Accounting Manager
Clerk of the Circuit Court Finance Department
Court Plaza III
?67 L Airport Load South
?vaples, FL 3'4 t 12