HomeMy WebLinkAbout2332 _ ~
~'7
Declaratian of Dan~icile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, _d
51. LUCIE COUN7Y, FLORIDA:
This is my declaration of Dom~ule and Citizenahip in the State of Floridz that I am filing this day in accordance and
in conformity witti Chapter 222, 5ection 222.17, Florida Statutes.
Virginiw
I was formerly a legal resident of .~tr~.b~li~ --x'!~~-Y'~-- -
fy~ {States)
and I resided at _ ~0~. 1~C11tuClc~ ~~si . _ _ _ - However I have changed my domic.ile
(STreet and Number)
to and am and have been a bona fide resident of the State of Florida since 18~ day of
_ ,~g],~ 19~ij , and I reside at _~7. _ ~~~dII ~Te~:
- - - - , - -
(Street and Number)
FORT PIERGE, SAINT LUCIE COUNTY, FLORIDA
anci this statement is to be taken as my declaration of citizenship, actual legal residente and damicile in the State of Florida.
(Insert here any periinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, remnval of family to new d~micile, purchase of home, etc.}
Eatabl.iahing z~ertidence
lht~eri.ag t~rolin in the llth grads
~E~ K
. . N ~c~ 800
. , i•,~ ~'b~~~ .
. ~ 5 ~ ~o .1 ~
. ~ . . ~ ~65 NOV ~
~ • . ~,L~.~'.,:.~. C~ERK ,
~ ~ ~ ~~~~yTY.
~ ~D~~~~UCIE
~LpR1D~+
I FURTHER CERTIFY that 1 will comply with all other rec}uirements of a legal resident of this State.
1 FURTHER CER7IFY that I have no intention to return to my former domitile, and I intend to remain in FOR7
PIERCE, SAINT,GUCIE COUNTY, FLORIDA, permanently.
7 ~ ~ - ~ / .
- - -
~ - - " PY`ibble (Nam~bI1A
~ '
(f~ddress)
~
,'J.
15th Mo~ember ~5
Sworn to and subscr~bed before me this day af , 19 .
ROGER POITR~lS - - - -
LERK CIRCUIT COURT Notary Public
g __"'c'"~ _ D.C. My Commission expires
Y
~(To bs exetuted in dupliute and origina! filed with ~Isrk Circuit Court, and dupliute with Tax Assessor.)
~o~x 130 533 ~