NOTICE TO APPLICANTS FOR LICENSES
ISSUED PURSUANT TO CHAPTER 493, FLORIDA STATUTES
MANDATORY DISCLOSURE OF SOCIAL SECURITY NUMBERS
Sections 493.6105, 493.6304, and 493.6406, Florida Statutes (F.S.), in conjunction with Section 119.071(5)(a)2, F.S.,
mandates that the Department of Agriculture and Consumer Services, Division of Licensing, obtain Social Security
numbers from applicants. Applicant Social Security numbers are maintained and used by the Division of Licensing
Department of Agriculture and Consumer Services, Division of Licensing, will not disclose an applicant’s Social Security
number without consent of the applicant to anyone outside of the Department of Agriculture and Consumer Services,
Division of Licensing, or as required by law. See Chapter 119, F.S., 15 U.S.C. ss. 1681 et seq., 15 U.S.C. ss. 6801 et
seq., 18 U.S.C. ss. 2721 et seq., Pub. L. No. 107-56 (USA Patriot Act of 2001), and Presidential Executive Order 13224.
ALL
QUESTIONS AND SUBMIT ANY DOCUMENTATION NECESSARY TO SUPPORT YOUR ELIGIBILITY.
SECTION I APPLICANT INFORMATION
• Must be at least 18 years of age.
• Must be a citizen or legal resident alien of the United States or have been granted authority to work in this country
by the Department of Homeland Security, U.S. Citizenship and Immigration Services (USCIS).
• Must provide current RESIDENCE address. A P.O. Box is not considered a residence.
SECTION II MILITARY HISTORY
service regulations, you must provide a complete and accurate account of this matter on a separate sheet of paper and
SECTION III CRIMINAL HISTORY
The Department will deny your application if you:
• have been convicted of a felony in any state or of a crime against the United States, which is designated as a
felony, or convicted of an offense in any other state, territory, or country punishable by imprisonment for a term
exceeding 1 year, unless and until Civil Rights have been restored and a period of 10 years has passed since
this application. Questions regarding the procedure for applying for restoration of Civil Rights or restoration of
• are currently serving a suspended sentence on a felony charge or on probation for a felony charge s.493.6118(4),
1
F. S..
The Department may deny your application if you:
• have a history of being arrested for crimes of violence and/or found guilty of (or had adjudication withheld for)
directly related crimes. This includes, but is not limited to: Trespassing, Breaking and Entering, Burglary, Robbery,
Forgery, Criminal Mischief or Theft, Assault, Battery, Stalking, Aggravated Battery, Aggravated Assault, Sexual
493.6118(1)(c), Section 493.6118(1)(j), Section 493.6118(3), F.S..
• have demonstrated a lack of respect for the laws of this state and the nation Section 493.6118(3), F.S..
• have an outstanding bench warrant or capias Section 493.6118(3), F.S..
• are currently in a Pre-Trial Intervention or Deferred Prosecution Program Section 493.6118(3), F.S..
dispositions. A determination of your eligibility cannot be made until all documentation is received and a
complete criminal history record check has been completed. This process takes 1-3 months.
SECTION IV ALIAS INFORMATION
If you are known by any other name, be sure to include it in this section. This includes nicknames, married names,