JODY PHILLIPS
DUVAL COUNTY CLERK OF THE CIRCUIT COURT
DOMESTIC RELATIONS DEPOSITORY
CHANGE OF ADDRESS FORM
501 West Adams Street
Jacksonville, Florida 32202
Fax: 904-255-2392
Change of address forms will not be processed unless this form is completed in full.
I authorize the Duval County Domestic Relations Depository to change my address.
Signed:
Date:
Please complete this form and mail or fax it back. Please print.
Your Name:
Your SSN:
Your Case No:
Daytime Telephone Number:
Your Old Home Address:
Your New Home Address:
City, State:
Zip Code
Your Date of Birth: ___________________________