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DECLARATION OF DOMICILE
To the Clerk of the Circuit Court (County Comptroller) Sumter County, Florida
This is my (our) Declaration of Domicile in the State of Florida, that I (we)
am (are) filing this day in accordance and in conformity with section 222.17,
Florida Statutes
FOR DOMICILIARIES OF THE STATE OF FLORIDA:
I (we) hereby declare that I (we) reside in and maintain a place of abode at
_________________________,____________________ in Sumter County Florida which
(Street Address)
(City)
Place of abode I (we) recognize and intend to maintain as my (our)
permanent home and, if I (we) maintain another place or places of abode in
some other state or states, I (we) hereby declare that my (our) abovedescribed residence and abode in the State of Florida constitutes my (our)
predominant and principal home, and I (we) intend to continue it
permanently as such. I (we) am (are) at the time of make this declaration, a
bona fide resident of the State of Florida residing at
_________________