Clerk of the County Court Recorder of Deeds Clerk and Accountant of the Board of County Commissioners Custodian of County Funds County Auditor NAME/ADDRESS CHANGE FORM DATE CASE NUMBER NAME NEW NAME NEW ADDRESS CITY STATE ZIP PHONE NUMBER E-MAIL ADDRESS EFFECTIVE DATE SIGNATURE Some or all information contained in this document will become public record. ANGELA VICK CLERK OF THE CIRCUIT COURT AND COMPTROLLER CITRUS COUNTY, FLORIDA 110 North Apopka Avenue Inverness, Florida 34450 Telephone: (352) 341 - 6 424 Fax: (352) 341 - 6 413 courts @clerk.citrus.fl.us www. American LegalNet, Inc. www.FormsWorkFlow.com