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SPECIAL MAGISTRATE APPLICATION <br />INDIAN RIVER COUNTY VALUE ADJUSTMENT BOARD. <br />(APPLICANTS MUST MEET QUALIFICATIONS OUTLINED IN FLA. STAT. & 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: Attorney Special Magistrate <br />❑ Appraiser Special Magistrate for... <br />❑ Real Property and/or ❑ Tangible Personal Property <br />If appointed, how much tUP9 would you be available to conduct hearings and complete your recommendations? <br />❑ 1 to 8 houis per week; 9 to 20 hours per week; ❑ 21 to 30 hours per week; ❑ 31 to 40 hours per week. <br />APPLICANT INFORMATION <br />Name: C.-l-,,IZ20 €-t7�L/�-- <br />Home Address: ef <br />Mailing Address:; O <br />Business Name: <br />Business Address: <br />Phone <br />Fax: <br />E -Ma <br />1 <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 htti)://dor.Lnyflorida.com/doL/proi)erty/vab/training. Return your completion <br />certificate to the VAB clerk. <br />Attorney Magistrate Applicant: Bar Number:/ 6,6 Date 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 />i General Appraiser License #: Valid Through: <br />i <br />Provide numlier 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 />cif <br />Page 1 <br />v01/13/2015 <br />—7— <br />