09/2015 Special District Reporting . SPECIAL DISTRICT REPORTING -
Sec<ion L89 416, Florida Statutes, requires that each special district in the state
designate a registered office and a registered agent and file this information with
the Department of Community Affairs and the local governing authority, Collier
County- Board of County Commissioners. Any changes in registered agent and
registered office must be reported to the above named agencies.
In the space below, please provide the correct name and address of your current
-egistered agent:
G66ee/
DISTRICT NAME: North Niarias Fire Control & Rescue District
REGISTERED AGENT: Fire Chief Ufty e, 5tat1-S
•
REGISTERED OFFICE: 1885 Veterans Park Drive
Naples FL 34109
In addition, please provide the telephone number of your registered agent:
PHONE NI-LIMBER: (239) 597-3172
Indicate your district's status (dependent or independent) by marking- and X in the
appropriate space. (See section 189.403, Florida Statutes, for definitions)
DEPENDENT IN-DEPENDENT 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 Johnssen, General Accounting Manager
Clerk of the Circuit Court Finance Department
Court Plaza III
2671 Airport Road South
Naples, FL 34112