HomeMy WebLinkAbout1719 Declaration of Domicile and Cltizenship
TO THE STATE AND COUiVTY iAX AS5ESSOR, j3$~~
51. LUCI~ COUN7Y, FLORIDA:
This is my detlaration of DomicilE and Cit~zenship in the State of Florida that I am filing ihis day in accordante and
in eonformity with Chapter ~22, Sectiori 222.17, Florida Statutes.
1 was formerly a legal resident of _ _ _~CI.S~1L . _ _ _ _ ___._~l_j.ZglIIj.i..~--__ _
(C+ty) (State)
6703 O~d Chesterbrook Rd
and I resided at _ _ - - _ _ _ _ . However I have changed my domic,ila
(Street and Number)
to and am and have been a bona fide resident of the State of Fforida since 24th day of
August ~9 65 and I res~de at $hit~~QCk _V~liaae A~t 4 F
(Street and Number)
~ORT PIEitCE, SAiNT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaratinn of. citizenship, actual legal residence and domicile in the State of Florida.
(Insert here ar~y pertinent facts, such as sale of properfy or business, or re~inquishnient of employment
at former domicile, rernoval of family to ne~v domicile, purchase of home, etc.)
lintering children in schoo2
~stabZishin~ residence
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1 Fl1RTHER CERTI~Y that I will corr~ply with all other requirements of a legal res;dent of this State.
I FURTH~R CERTlFY that I have no intention to return ta my former domic~fe, and I intend to remain in FORT
.
PIERCE, SAiN~, LUCIE COUN7Y, ~LORIDA, permanently.
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Sworn to and subscribed before me this 3~~t day of ______AtigUSt 19 6$
- ,
ROGER POlTRAS
K CIRCUIT COURT Notary Public
~
gY ~'~'e'~ D.C. My Commission ex~ires _
(Ta bs sxscutrd in duplicate and ariginal filed with Cleric Ci~cui! Co~rt, snsl dupticste with Tax /lssessor.j
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