La Gaceta Newspaper

Information to be published

Business Name:* (name you are registering)

Owner's Name*

Business Address*:

City*:

State*: —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

ZIP*:

Information for our records

Please mail the affidavit and paid invoice to me at the address below.Please email the affidavit and paid invoice to me at the email address below.

Name of person placing ad*:

Phone No*

Email*

Address*

City*:

State*: —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

ZIP*:

County to Publish Ad In*

CitrusHernandoHillsboroughManateeOrangeOsceolaPascoPinellasPolkSarasota