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3. Tavares Police Department, 911 Gateway Drive, Tavares, FL 32778 Telephone 352-742-6200 Fax 352-253-4269 Email: golfcart@tavares.org

4. 
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Phone Number*
18. E-Mail address*
22. Make of Golf Cart?*
24. Model of Golf Cart?*
26. Serial number on Golf Cart?*
28. Color?*
30. Seat Color/Print?*
32. UNIQUE IDENTIFYING MARKS?
34. Please provide any additional information that you would like the City of Tavares Police Department to know about your golf cart:
38. Certificate of Applicant

    I certify that the answers given on this application are true and complete to the best of my knowledge. I agree to inform the City of any additional information relating to questions raised on the application, which occur subsequent to my completion of the application. I realize that misrepresentation of facts or the failure to update any information relating to questions on the application may be cause for the rejection of this application. I release the City of Tavares and all other parties from any and all liabilities or claims for any damage that may result therefrom. Each party agrees that the electronic signatures on this document, whether digital or encrypted, are intended to authenticate this application and to have the same force and effect as manual signatures.

40. Signature*

    Type your full name

41. Date*
    Date
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42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

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