Dfs A4 Form PDF Details

Did you know that there is a specific form that you need to fill out in order to file a DFS (Department of Family Services) case? If you're not sure what this form is or where to find it, keep reading! In this blog post, we'll provide all the information you need to know about the DFS A4 form. We'll also give some tips on how to fill it out correctly. So don't miss out – keep reading!

QuestionAnswer
Form NameDfs A4 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesflorida form dfs a4 2007, 2007 form a4, dfs a4 form, dfs a4

Form Preview Example

NOTARIZED SWORN STATEMENT OF THE CLAIMANT

Claim Number _________________

After being duly sworn, the affiant states as follows:

1.My full name is ___________________________________.

2.My current address is ____________________________________________

Street Address

______________________________________________________________

City

County

State ZIP Code

3.My date of birth is: month ___________________, date_________, year____________

___________________________

Signature of Affiant

STATE OF

)

COUNTY OF

)

Sworn to and subscribed before me this_________ , day of

___________, _____, by _________________________________.

(Month)

(Year)

(Name of person making statement)

__________________________________

(Signature of Notary Public)

_________________________________________________________

(Print, Type, or Stamp Commissioned Name of Notary Public)

______________________________________________________________

Address of Notary

______________________________________________________________

City

County

State ZIP Code

*Notary must identify the type of government issued photographic identification produced that verifies Affiant’s name and date of birth as stated on this form above.

Type of identification shown to Notary by Affiant (such as a drivers license, state identification card, passport, or other similar valid government issued photographic identification): ________________________________

*Pursuant to Section 717.124(1), FS, the claimant must produce to the notary photographic identification of the claimant issued by the United States, a state or territory of the United States, a foreign nation, or a political subdivision or agency thereof.

Form DFS-A4-2007, Effective 10-13-10, incorporated into Rule 69I-20.0022, F.A.C.

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Completing segment 1 of dfs a4 2007 form

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