declaration of domicile – declaracion de domicilio

DECLARATION OF DOMICILE – DECLARACION DE DOMICILIO
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
Esta es mi Declaración de Domicilio en el Estado de la Florida, la cual registro en el día de hoy; conforme al estatuto de la Florida Sección 222.17
.
FOR DOMICILES OF THE STATE OF FLORIDA – PARA DOMICILIOS EN EL ESTADO DE LA FLORIDA
I hereby declare that I was formerly a legal resident of, and I resided at: Yo declaro que mi residencia legal y anterior fue:
(1)
__________________________________ __________________________ ___________ ____________________
Street Address (número y nombre de calle)
City (ciudad)
State (estado)
Country (país)
However, I have changed my domicile to, and have been a bona fide resident of the State of Florida since the
Pero, he cambiado mi domicilio principal al Estado de la Florida desde:
(2)
________ day of _________________, ________. I now reside at (ahora mi residencia principal es):
Date (día)
Month (mes)
Year (año)
(3)
______________________________________ ___________________________________, Broward County, Florida.
Street Address (número y nombre de calle)
City (ciudad)
This statement is to be taken as m y declaration of actual legal resi dence and permanent domicile in this State and C ountry to the exclusion of all other s
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, owned by me and/or my spouse, and carry all statutorily required motor vehicle insurance. If I vote, I
must vote in the precinct of my legal domicile and I understand that my estate will be probated in the Florida Courts.
Also living with me at this address (También viviendo conmigo en esta residencia)
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
(4)
Signature (Firma):_______________________Signature (Firma):________________________________
(5)
Print Name (letra molde):______________________Print Name (letra molde):___________________________
State of Florida
County Broward
Sworn to (or affirmed) and subscribed before me this (Juró o afirmó ante mí hoy)_____ day of _____________,_______.
Personally Known (conocido) ____ OR Produced (presentó) _____________________________________________ as Identification (como
identificación).
Signature of Notarizing or Attesting Official (firma de Notario Público o Diputado) ________________________________(seal) (sello)
FOR DOMICILES OF STATES OTHER THAN THE STATE OF FLORIDA - DOMICILIOS FUERA DE LA FLORIDA
I hereby declare that my domicile is in the State of (Yo declaro que m i domicilio es en el Estad o de) __________________ and that I intend
permanently continue and maintain my domicile in such state. At the time of making this declaration I am a bona
to
fide resident o f the State of (y soy
residente de el Estado de) ______________. My place of abode w ithin the Stat e of Florida, if any, is as follow s: (Here list street address, city , and
county of place of abode in Florida.) Mantengo una residencia en (Ciudad, Estado, código postal) Florida:
_________________________________________________________________________________________________________________________
(Person making declaration may also include such other and further facts with reference to any acts done or p erformed by such person that such
person desires or intends not to be construed as evidencing any intention to establish his domicile within the State of Florida.) o registro addicional.
State of Florida
County Broward
Sworn to (or affirmed) and subscribed before me this (Juró o afirmó ante mí hoy) _____ day of (de) ________________, __ ____________. Personally
Known (conocido) ________ OR Produced (presentó) _______________________________________________ as Identification (como identificación.)
Signature of Notarizing or Attesting Official (firma de Notario Público o Diputado) ____________________________-_________________(Sea) (Sello)
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