Form Clk/ct 578 - Declaration Of Domicile
Download a blank fillable Form Clk/ct 578 - Declaration Of Domicile in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Clk/ct 578 - Declaration Of Domicile with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1PLEASE USE TAB OR MOUSE
DECLAR ATIO N O F DOM I CI LE
TO TH E STATE O F FLOR I DA AND
COUNTY O F M I AM I -DADE:
This is my Declaration of Domicile in the State of Florida that I am filing
this day in accordance, and in conformity with Section 222.17, Florida
Statutes.
I, ____________________________________________ was formerly a legal resident of ________________________________
(Print Name)
(City)
_____________________and I resided at ___________________________________________________, however, I have changed my
(State)
(Street Address)
now
Domicile to and have been a bona fide resident of the State of Florida since the _____day of_____________________, 20_____. I
reside at ________________________________________________________, _____________________________.
(
(
Street Address)
City)
Miami-Dade County, Florida, and this statement is to be taken as my declaration of actual legal residence and permanent domicile in this State
and County to the exclusion of all others, and I will comply with all requirements of legal residents of Florida.
I understand that as a legal resident of Florida: I must purchase Florida license plates for motor vehicles, if any, owned by me, and/or my
spouse; if I vote, I must vote in the precinct of my legal domicile and that my estate will be probated in the Florida Courts.
Yes No
I was born in the U.S.A.:
Place of Birth:
_______________________________________________________
Naturalized Citizen - Where: _______________________ Date: _____________________ No. _____________________________
Lawful Permanent Resident: Date: _________________ N o . _______________________________________________________
________________________________________________________
(Signature)
_________________________________________________________
Print Name)
(
_________________________________________________________
(
Mailing Address)
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
Sworn to and subscribed before me this _______ day of ____________________________, 2 0 _______,
by __________________________ personally known to me or who has produced a _______________________ as
identification and did take an oath.
__________________________________________________________
Signature of Notary Public, State of Florida
__________________________________________________________
Print, Type or Stamp name of notary
PRINT
SAVE
RESET
You are required to fill-out and notarize the form. When complete, bring or mail original to the County Recorder’s Office at 22 NW
st
1
St., Miami, Florida 33128 with a $10 (money order or cash if coming in person) and a self-stamped addressed envelope.
Penalty for perjury: up to five (5) years in State Prison and $5,000 fine (F.S. 837.02)
CLK/CT 578 Rev. 06/16
Clerk's web address:
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal