HomeMy WebLinkAbout2081 ~ . ~ . _ - - i
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~ D~taratlon of Donni+~llt and Citis~nshlp
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> TO TNE STATE AND COIii~TY TAX A55ES.SOR,
~ 51. lUC1E COUNTY, FLORIOA: '
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ihis is my declaration of Domicile and Citiztnship in the 5tate of Florida that I am fili~g this day in acco?danoe and
in conformiiy with Chapter 222, Section 222.17, ~lorida Statutts.
I wns formerly a legal resident of $Firt~bnz~_________ South Ca~roli.,~a _ ~
(City) (Srers)
1301 Boiling Springa ROad , Howaver 1 have change:d my domi~ile :
ancf t resided et _ _
(Strast ar?d Number) .
to and am and havc been a bona fide resident of the State of Florida since _20__,_____ day of ~
- ' Augnat 6S 1714 PoACe De Leen Pradeo
, 19--_--, and 1 reside at
~ (Street and Number)
FORT PtERCE, SAtNT LUCiE COU~tTY, fIORIDA
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and this statement is to be taken as my declaration of citi2enship, actual legal residence and domicile i~? the State of ~lorida.
(Insert here any pertinent facts, such as sale of property or business, or retirsquishment of employment
at former domicile, removal of family ta new rlomicile, purchase of home, etc.)
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'65 S~P .
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fistab.tishiag xesidence
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St. LUCIE ~p~N YRK
- ~at~red children in ~chool fi«RtDA ,
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I FURTMER CERTf~Y that { will compiy with all other requirements of a legal resident of thi~`5~dit~t.,'~
I FURTHER CERTIFY that I have no inTention to return to my former dami~iie, and I intend to remain in FORT
PfERCE, 5A1N7 LUCIE CC3UN1'Y, FLORIDA, permanently. ~
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.:~t~'-! . (Name)
~,y
. ~ ~ ~ ; ~',~~~`,e+I t'~A~ i IS ' ,4',. ~ '
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' ' .s y ~ . Ga.deon M, Lo~B. .Tx.
. ~.s` (Address)
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~Swosrn lo~ar~d s~bseribed before me this 9 day of -~t' te~~r , lq.~.~.
R~1GHt POITItAS
CLERK CI IT COURT Notary Pubtic
By D.C. My Commission expires _
fCa b~ ~x+cvt~d in drrpiicaro and original ~rlsd wiNt qe~lc Circait Gowrt, ~nd dupfic~rte wFth Tax As~s~or.) _
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