Fillable Declaration Of Domicile Form - Florida printable pdf download

Declaration Of Domicile Form - Florida

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DECLARATION OF DOMICILE

TO THE STATE OF FLORIDA AND COUNTY OF CLAY:

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 Statues.

I _________________________________________________________ was formerly a legal resident of

(please print name)

and I resided at ____________________________________ however,

________________________________________________________________

(city and state)

(street address)

I have changed my domicile to and am and have been a bona fide resident of the State of Florida since the

________ day of __________

I now reside at __________________________________________

,20 ______ .

Clay

(street address)

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 am subject to intangible taxes; I must purchase Florida license

plates for motor vehicles, if any, owned by me and/or my spouse; I must vote in the precinct of my legal domicile (if

I vote), and that my estate will be probated in the Florida

Courts.

I was born in the USA: Yes_________ No______ Place of birth:

Naturalized citizen ______ Where: __________________________ Date:_________ No.: _______________

Permanent Visa: Yes ________No _____ Date ___________ No.: __________________________________

State of Florida

County of CLAY

Signature as printed above

Sworn to (or affirmed) and subscribed

before me this ______ day of _________

,20

by _____________________________________

Mailing address

____ Personally known

____________________________________

City / State / Zip

____ Produced identification

(type of identification)

(Signature of Notary/Deputy Clerk)

(Type or print name)

Penalty for perjury --- up to 5 years in state prison --- (Section 837.01, Florida statutes)

Declaration Of Domicile Form - Florida

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