__________________________________________ _________________________________________________ DECLARATION OF DOMICILE (THIS IS NOT A HOMESTEAD EXEMPTION APPLICATION) PENALTY FOR PERJURY - up to 20 years in state prison (Section 837.01, Florida Statutes) TO THE CLERK OF COURTS CHARLOTTE COUNTY, FLORIDA 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 ______________________________, _____________________ and I resided at CITY STATE ________________________________________________________________ however, I have changed my domicile STREET AND NUMBER and have been a bona fide resident of the State of Florida since the _______day of_____________________,20____. I now reside at _____________________________________________________________________Charlotte County, STREET AND NUMBER CITY 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. STATE OF FLORIDA COUNTY OF CHARLOTTE Sworn to (or affirmed) and subscribed before me by means of __ physical presence or __ online notarization, this__________ day of________________________, _____, by______________________________________________ who is personally known or who provided identification. Type of I D________________________________________ Notary Signature ______________________________________________ PRINT NAME ______________________________________________ SIGNATURE ______________________________________________ PRINT NAME (SPOUSE) ______________________________________________ SIGNATURE (SPOUSE) ______________________________________________ MAILING ADDRESS ______________________________________________ Sworn to and subscribed before me this____ day of ______________________________, 20_____. CLERK OF THE CIRCURT COURT ___________________________________________ Deputy Clerk Signature 10/16/2020 Version 2.0 Page 1 of 1
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DECLARATION OF DOMICILE (THIS IS NOT A HOMESTEAD EXEMPTION APPLICATION)
PENALTY FOR PERJURY - up to 20 years in state prison (Section 837.01, Florida Statutes)
TO THE CLERK OF COURTS CHARLOTTE COUNTY, FLORIDA
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 ______________________________, _____________________ and I resided at CITY STATE
________________________________________________________________ however, I have changed my domicile STREET AND NUMBER
and have been a bona fide resident of the State of Florida since the _______day of_____________________,20____.
I now reside at _____________________________________________________________________Charlotte County, STREET AND NUMBER CITY
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.
STATE OF FLORIDA
COUNTY OF CHARLOTTE
Sworn to (or affirmed) and subscribed before me by means of
__ physical presence or __ online notarization,
this__________ day of________________________, _____,
by______________________________________________
who is personally known or who provided identification.
Type of I D________________________________________
Notary Signature
______________________________________________ PRINT NAME
______________________________________________ SIGNATURE
______________________________________________ PRINT NAME (SPOUSE)
______________________________________________ SIGNATURE (SPOUSE)
______________________________________________ MAILING ADDRESS
______________________________________________
Sworn to and subscribed before me this____ day
of ______________________________, 20_____.
CLERK OF THE CIRCURT COURT
___________________________________________ Deputy Clerk Signature
10/16/2020 Version 2.0 Page 1 of 1
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