HomeMy WebLinkAbout0206 DeClaration ot C~om~cile and Citisenship
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TO THE 5TATE ANU COUNTY TAX ASSESSt~R, _I_4t~~{1~
Sl. LUCIE COUNTY, ~IORtDA:
This is my declaration of pomicile and Citizenship in the State of ~(orida that I am filing this day in atcordance atx)
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of $ip~li~d M~~shig~__ ~
(CitY) (State)
and ! resided at , ~9 No~'th RirA2` Joes~ Nowever 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 . day of
- ~iQV~a~ea~_ 19b5 _ and i reside at 3L{l7_ --B7=''on
(Street and Number) ~ ~ l
fORT PtERCE, SAlWT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flnrida.
(Insert here any pertinent facts, such as sal~ of property or business, or relinquishment of employment
at form~r dnmicile, removal of family to new damicile, purchase of home, et~.)
~ntering children in school ~
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I FUt2THER CERTIFY ihat I will comply with all other requirements of a legal resid~nt of this State.
I Fl1RTHER CERTI'rY that ! have no intention to return ta my farmer damic,ile, and ! intend to remain in FORT
PIERCE, SAINT LUCIE CUUNTY, FLORIDA, permanently.
j` Y`r- ' - ~
_ . (Nam
" Mrs.~~ond ~eitael
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(Address? ~
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':'S ",c,~n~t~~ilitd subscribed before me this ~'7~~._ da of ~ _ ~9~~~r ~
~ Y - - - 19 ~ .
6tOGER POITRAS _
K CIRCUIT C RT hlotary Public
c~..~~z.c...~ ~~L. .~t~t--GC'r
g t~.C. My ~ommission expires
(fio be exscuted in duplic~?te a~d o~i~inat filed w+th Ciark Circvit Court, ,rnct duplicah with Tax Assesa~or,)
60QK
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