To fill out the PDF format of this form, right click and "Save Target As" to your desktop or documents folder.
Open the saved PDF with Adobe Reader.
Once the document is open, click on the "Sign" button in the top right corner of the toolbar. This feature of Adobe Reader will take you through steps to fill in the spaces provided. Add text in the appropriate fields.
When the form is complete, click on the "Place Signature". Type your name and drag that to the bottom of the form.
Click on "Done Signing" and save to your desktop or documents folder. Do not use the "send signed document" as this will launch a website.
NOTICE OF CUSTODIAN OF PUBLIC RECORDS: The City of Titusville has designated the City Clerk, Wanda Wells, its Custodian of Public Records pursuant to Chapter 119, Florida Statutes. Anyone wishing to inspect or copy public records consistent with Florida law should contact the
Custodian of Public Records at:
City of Titusville | Custodian of Public Records | Wanda Wells, City Clerk | 555 South Washington Avenue | PO Box 2806 (32781-2806) | Titusville, FL 32796 | Phone: (321) 567-3775 | Send Email: Brenda.Evans@Titusville.com
Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.
This website is undergoing remediation, please contact the Digital ADA Coordinator for any needs until such time as the remediation is completed.