HomeMy WebLinkAbout0409 De~ciaration of Domicile and Citiz~nship ~
TO THE STATE ANp COUNTY' TAX ASSESSOR, ~~~5
51. LUCIE COUNTY, FLORIbA:
This is my detlarotion of Domicilc and CiPizenship in the State of Florida fhat I am filing this day in accordance and
in conformiry with Chapte~ 222, 5ection 222.17, Fl~orida Statutes.
I was fo~merly a legal resident of ~_L~1II$h~----.-------- - ys~~ -
~C;ty~ (Stata)
and 1 resided at _____12__.~ffi~id-~tttL't However ! have changed my domic.i{e
(Street and Number)
24th
to a~d am and have been a bona fide resident of the State of Florida si~ce . _ day of
_ 3y~~_-_ 19.~~, and I reside at 3159 O'v ~Stree and Number) ~
FORT PIERCE, SAINY LUCIE COUNTY, FLORiDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and dnmicile in the St~te of Florida.
(Insert here any pertinent fatts, such as sale of property or business, or relinquishment of employment
at former domic+le, removal of family to new domicile, purthase of home, et~c.)
~ Bstablishing residency ~~~~E AroD RECORp~
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I FURTHER CERTiFY that I will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domi~ile, and I intend to remain in FORT
PIERCE, SAINT LUCIE CQUNTY, FLORIDA, permanently.
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'r~, • ~ Willia~ ~~a ~htvalier
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Swartl~f?l'b~nd subscribed before me this j__- day of - .
AOGER POITRAS
CIRCUlT COURT Notary Public
gy ~~v"L""~ D.C. My Commission expires
(To b. •x.cuted in duplicsro and oripinal ~ited with Gtrk Circuit Gou~t, snd duplicah wifh Tax Ass~ssor.)
~oGK 227 .4i~9