Florida Department of Education Bureau of Educator Certification Room 201, Turlington Building 325 West Gaines Street Tallahassee, FL 32399-0400 District Number Communication Number I V A N 9 1 6 Natural Disaster Extension/Fee Waiver Applicant’s Personal Information Social Security Number First Name Middle Name Last Name Special Extension/Duplicate Certificate Request Form Extraordinary, Extenuating Circumstances Relating to Hurricane Ivan September 16, 2004 The educator identified above is an employee ... Duplicate certificate, pursuant to Section 1012.56(14), Florida Statutes. (CG-10 Form required: $20 fee waived) _____________________________________________________ ...
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