HomeMy WebLinkAbout2628 • ~ ~.w N ~e -
: Decla~,ation ot ~omicile and Citizenshi . a
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; TO THE STATE M10 COUNTY TAX IISSESSOR, ~ ~,,,,,s~O
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; S1. LtJC1E COUNTY. fLORIDA:
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This h my declaratlon of Domkils and Citissnship in th~ St~t~ of Florida that 1 am Hiinq this day in aooord~nos ~~d
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~ i~ oonformtty witF~ Chapter 2Z4, Ssction 22Z.17, Ftorida Statutes.
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~ i was ~i , ~ ~lls alade P'lorida
y aqal testdent of
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and 1~id~! at x~~ St]C'eeL
How~ t haw cfiup~d my domidl~
~ (Street and Number)
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b snd sm and have besn s bona fids r~tdsnt of tl~s Stsfs of FIaWa sina ' ~ day of
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~ ~ Sep'~ y 19~LQ_._, ~nd i~Id~ at ~1'~R g~ 7~-.~ ~'se'L- • .
(Strsat ~~d Numl~?)
` lO~T NE~. SAINT lUC1E COUNTY, RORIDA ~
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~ ar~d thti :tatemsnt ii to bs take~ es my dedaretian:of dN~ship, actval lepal resWsnoe and domidl~ tn t!w Stab of Horida.
! qnssrt hero any psrtinsnt facn, such as ssle of properry or bu:insu, or relinqui:hm~nt of employme~t
i at ~msr domidle, removal of famtl to new domidk
~ . Y . Purchass of honne, ftc.)
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~ Shtering ohiidran in 4th snd t
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] i RJRTHER Ct~tT1FY tfiat ! wIR aomply wHh s!! o~r roquinrr~nK o~f a Ipal raWent of thb St~tr.
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1 FURTHER CERTIFY that 1 hsve no intention to tetum to my formsr domidle, and f intend t~o ~main tn fORT
PIERCE, S/41NT LUCIE COUNTY, FLORIDA, permanently. •
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. ~ . Notary Rubik ~ '
, D~• NIy Comn~uton ~xpi~
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