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SPECIAL MAGISTRATE APPLICATION <br />INDIAN RIVER COUNTY VALUE ADJUSTMENT BOARD <br />(APPLICANTS MUST MEET QUALIFICATIONS OUTLINED IN FLA. STAT. 6 194.035) <br />Please type or print: If more space is needed, attach additional sheets. Applicants may supplement their application <br />with a resume: However, a resume cannot be used in lieu of an application <br />Application for: MAttorney Special Magistrate <br />0 Appraiser Special Magistrate for... <br />0 Real.Property and/or 0 Tangible Personal Property <br />If appointed, how much time would you be available to conduct hearings and comp your recommendations? <br />0 1 to 8 hours per weelc; ❑ 9 to 20 hours per week; 0 21 to 30 hours per weelc;4 31 to 40 hours per week. <br />APPLICANT INFORMATION <br />Name: <br />4.9 va <br />Home Address: �D t s�/`e.0 �3 e X 6 ¥F / <br />Mailing Address: /9-(/'V � F -zee <br />Business Name: <br />Business Address: <br />Phone: Home/ <br />Fax: <br />Business/ <br />8.B. <br />Cell/ 7 7a- 7/ 3 -/Dg? <br />E -Mail: <br />13& L1 �J -7'�72G./st-eG' CG r`7 <br />DOCUMENTATION REQUI:RE,D <br />Verification of qualifications will be made prior to consideration of this application, pursuant to FS 194.035. <br />• Copy of license referenced below. <br />• Documentation to support membership in professional organizations listed below under Organizations. <br />• A writing sample, which may consist of an opinion letter or other business-related documentation that <br />contains one or more written pages of original material. If you have served as a special magistrate <br />previously, please submit a recommended decision as your sample. Do not submit a copy of an appraisal <br />as a writing sample. <br />• Prior to conducting hearings, all applicants are required under Fla. Stat § 194.035 to certify completion of <br />the current year training provided by the Department of Revenue. To obtain the training, go online to the <br />Department's website at ittp://dor.myflorida.com/dor/property/vab/training.html. Return your completion <br />certificate to the VAB clerk <br />L'I C E N S U R E /'EXPERIENCE <br />Attorney Magistrate Applicant Bar Number: /57-4 ‘‘ate of Admission: <br />How many years of experience do you have in the area of ad valorem taxation: <br />Appraiser Magistrate Applicant: Residential Appraiser License #: Valid Through: <br />General Appraiser License #: Valid Through: <br />Provide number of years of experience you have in the area of real property valuation: <br />Describe experience, and number of years you have in the area of tangible property valuation: <br />Page 1 <br />v01/13/2015 <br />-17- <br />