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Declaration Of Termination Of Domestic Partnership - Florida
| Declaration Of Termination Of Domestic Partnership Form. This is a Florida form and can be used in General Palm Beach Local County . |
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Return to _________________ _________________ _________________ DECLARATION OF TERMINATION OF DOMESTIC PARTNERSHIP I swear or affirm under penalty of perjury that: 1. 2. 3. I am a partner in a registered domestic partnership established in Palm Beach County, Florida. My registration number is ___________________. The Domestic Partnership has been dissolved. I have notified my domestic partner of the termination of this Domestic Partnership as indicated by either: a. _____ My partner has joined in this Declaration of Termination by signing below in the presence of a notary or a deputy clerk; OR b. _____ Notice was delivered to my former Partner by registered or certified mail, return receipt requested at his/her last known address. I have provided the proof of service (return receipt) to the Clerk and Comptroller's office as required. I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this petition and that the punishment for making a false statement includes fines and/or imprisonment. Partner Filing Declaration of Termination of Domestic Partnership Printed Name Address Signature STATE OF FLORIDA COUNTY OF PALM BEACH Sworn or affirmed and signed before me on _________________________________ _________________________________ Notary Public or Deputy Clerk of Court __________________________________ [Print, type or stamp commissioner name of notary or clerk] City, State, Zip _________ by American LegalNet, Inc. www.USCourtForms.com Declaration of Termination of Domestic Partnership Page 2 Partner Joining Declaration of Termination of Domestic Partnership Printed Name Address City, State, Zip Signature STATE OF FLORIDA COUNTY OF PALM BEACH Sworn or affirmed and signed before me on _________________________________ _________________________________ Notary Public or Deputy Clerk of Court __________________________________ [Print, type or stamp commissioner name of notary or clerk] _________ by American LegalNet, Inc. www.USCourtForms.com
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