Affidavit of Florida Resident

AFFIDAVIT OF FLORIDA RESIDENT Return a recorded copy of this form to: Lake County Property Appraiser Attn: Exemptions Department 320 W. Main St. Suite A Tavares, FL 32778-3814 INSTRUCTIONS: If requested by this office as part of your application for exemption, you must complete and sign this form in the presence of a notary public. This form must then be recorded with the Lake County Clerk of the Court Recording Division. Phone: (352) 253-2600. After recording, return a copy to the Lake County Property Appraiser.

Before Me, the undersigned authority, personally appeared ____________________________________, who being by me duly sworn depose(s) and say(s): I (we) are permanent residents of Lake County, Florida since:___________________________________. I (we) reside at: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Which is my (our) permanent residence, and I (we) intend it to continue as such. If I (we) maintain a residence in any other state or Florida county, such abode is not my (our) permanent residence, nor do I (we) have any intent to make it so, now or in the foreseeable future, and I (we) will comply with all requirements of legal residents of Florida. I (we) understand as a resident of Florida I (we) must purchase Florida license plates for my (our) vehicles and I (we) must have a valid Florida driver license and if I (we) vote, I (we) must vote in the precinct of my (our) legal Domicile and that my (our) estate will be probated in the Florida Courts. This document is executed and recorded for the purpose of supporting an application for homestead exemption pursuant to Florida Statute Chapter 196. _____________________________________________________________________________________

_____________________________________________________________ Signature of Resident(s) This section to be completed by Notary Public.

Acknowledgement: ____________________________________________________ personally appeared before me and executed (name of person(s) signing affidavit) the foregoing instrument freely and voluntarily for the purposes therein expressed. Witness my hand and official seal this __________ day of ____________________, 20 ______. PERSONALLY KNOW TO ME __________ OR PRODUCED IDENTIFICATION _________________ TYPE OF IDENTIFICATION PRODUCED _______________________________________________ _______________________________________ Notary Public Signature

Place Official Notary Seal Here:

_____________________________________ Notary Public Name Printed