Fillable DECLARATION OF DOMICILE/DECLARACIN DE DOMICILIO (Marty Kiar Broward County Property Appraiser)

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DECLARATION OF DOMICILE/DECLARACIN DE DOMICILIO (Marty Kiar Broward County Property Appraiser)

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DECLARATION OF DOMICILE/DECLARACIÓN 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, que estoy registrando en este día de acuerdo y en conformidad con la Sección 222.17, de los Estatutos de
la Florida.
1. I hereby declare that I am a bona fide resident of the State of Florida, and reside in and
maintain a place of abode at: Por la presente declaro que resido y mantengo mi residencia en:
__________________________________________________________________________
Address/
Dirección City & Zip Code /Ciudad y Código Postal
which place of abode I recognize and intend to maintain as my permanent home and, if I maintain another
place or places of abode in some other state or states, I hereby declare that my above-described residence
and abode in the State of Florida constitutes my predominant and principal home, and I intend to continue it
permanently as such.
Como lugar de residencia el cual reconozco e intento mantener como mi hogar permanente. De
mantener otro lugar(es) como residencia(s) en cualquier otro estado(s), yo declaro en la presente que mi residencia
descrita anteriormente y hogar en el Estado de Florida constituye mi hogar principal y predominante, y mi intención es
continuar de esa manera permanentemente.
2. I formerly resided at:
Mi residencia anterior fue:
__________________________________________________________________________
Address/
Dirección City, County, State and Zip Code/Ciudad, Condado, Estado y Código Postal
3. The place or places where I maintain another or other place or places of abode are as follows:
El(los) lugar(es) donde mantengo otra(s) residencia(s) son los siguientes:
__________________________________________________________________________
Address/
Dirección City, County, State and Zip Code/Ciudad, Condado, Estado y Código Postal
______I intend to permanently continue and maintain domicile in the State of ____________________________.
______Mi intención particular es seguir residiendo permanentemente en el Estado de ______________________.
______I intend to be or become domiciled in the State of Florida.
______Mi intención particular es residir permanente en el Estado de la Florida.
Optional: Also residing at this address: Opcional: Viven conmigo en mi dirección actual:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Signature:/
Firma: ______________________________ Signature/Firma: ________________________
Print Name: /
Imprima Nombre: _____________________ Print Name: /Imprima Nombre: _______________
STATE OF FLORIDA
COUNTY OF BROWARD
Sworn to (or affirmed) and subscribed before me this ______day of _______________________________, ___________.
Personally Known ______OR Produced __________________________________________________ as identification.
Signature of Notarizing or Attesting Official_____________________________________________________________
(Seal
)
Revised 08/01/2017 JA
DECLARATION OF DOMICILE INSTRUCTIONS
All information must be legible.
Husband and wife, domestic partners, or others who cohabit may sign the same form.
The Declaration of Domicile form must be notarized. Notary services are available in our office, or you may
use a Notary Public of your choice. The fee for our Notary service is $10.00 per document, in addition
to the standard recording charges. Please note that all persons who signed the document must appear
before the notary.
Have your identification available. You need to have current government-issued picture identification in
order for this office to notarize your signature, such as a driver’s license, a state identification card, or
passport.
COMPLETING THE FORM:
Line
(1)
Fill in your current address.
Line
(2)
Fill in the last address of where you lived before you moved to your current address
Line
(3)
Other places where you maintain abode. Please mark your choice accordingly. Optional line.
Sign
Clearly and legibly PRINT the name that you signed.
GETTING YOUR DOCUMENT RECORDED:
You may record through the mail or in person. If you record thru the mail, your document must be
notarized before you send it to us.
Mail to:
RECORDS, TAXES AND TREASURY
115 S. Andrews Ave
Room 114
Fort Lauderdale, FL 33301
Include a self-addressed, postage paid envelope for the return of the document after processing
The recording fee is $10.00 for a one-page document
Make check or money order payable to: BOARD OF COUNTY COMMISSIONERS (do not send cash)
If you want a certified copy of recorded document in addition to the recorded original we will send you, add
$3.00 to your payment for each certified copy requested. A certified copy is optional.
In person:
County Records office is at the Governmental Center, and it is open Monday through Friday (except holidays)
from 7:30 am to 5:00 pm.
STREET ADDRESS:
Governmental Center, Room 114
115 South Andrews Avenue
Fort Lauderdale, Florida 33301
Revised 03/27/2018 JA
INSTRUCCIONES PARA REALIZAR SU DECLARACIÓN DE DOMICILIO
Toda la información debe estar legible
Esposos, parientes domésticos o cualquier otra forma de coexistencia (incluyendo relación padre-hijo)
puede ser reportada en el mismo formulario.
La Declaración de Domicilio debe estar notarizada antes de ser sometida a grabación pública. Usted
puede optar por Notarizar sus declaraciones en nuestra oficina por un cargo adicional de $10 por
documento adicional al cargo de grabación pública. Si decide notarizar el documento en nuestra
oficina recuerde que todas las personas deben presentarse ante el Notario al momento de firmar.
Tenga su identificación lista y no firme hasta que se le indique. Esta identificación debe estar al día y
ser una identificación elaborada por cualquier departamento gubernamental tal como la Licencia de
conducción, Tarjeta de identificación del Estado o Pasaporte.
Complete la Forma:
Línea 1-Direccion actual
Línea 2-Direccion anterior a la actual
Línea 3- Solamente si mantiene residencia fuera del estado de la Florida. Si usted completo la línea
3, por favor escoja una de las siguientes opciones:
____Mi intención particular es seguir residiendo permanentemente en el Estado de____.
____Mi intención particular es residir permanentemente en el Estado de la Florida.
Firme ante el Notario Público cuando se le indique
Coloque su nombre en letra de imprenta lo más claramente posible.
Poner su documento a grabación Publica:
En persona o por correo
Precio $10.00 (Solamente si el documento es presentado a la oficina previamente notarizado)
Por correo:
Recording Section
115 S. Andrews Ave
Room 114
Fort Lauderdale, FL 33301
Incluya un sobre estampillado para su devolución
Cheque o Money Order pago a Board of County Commissioners (Por favor no envíe efectivo!)
Si usted desea una copia certificada del documento original envíe $3.00 adicional ($1.00 por
documento y $2.00 por la certificación) por cada copia. La copia certificada es opcional.
En persona:
Las horas de oficina son Lunas a Viernes excepto los días festivos de 7:30 am a 5:00pm
Nuestra oficina ofrece servicios de notarización y está disponible solamente en persona, La cuota es de $10.00 por
cada documento a notarizar. La/las persona(s) que firma debe tener una identificación legal.
Dirección:
Edificio Gubernamental
Records Section-Oficina 114
115 South Andrews Ave
Fort Lauderdale, FL 33301 Revised 08/01/2017 JA
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DECLARATION OF DOMICILEDECLARACIN DE DOMICILIO (Marty Kiar Broward County Property Appraiser)

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Completed 20 January 2021

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