HomeMy WebLinkAbout0880 Decl~ration of Domicile and Citizenship
TC) THE STATE AND COUNTY TAX ASSESSOR,
.14C~:1t~
51. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile ar~d Citizenship in the State of Fiorida that I am filing this day in accordante and
in conformity with Chapter 222, Section 222.17, Florida 5latutes
! was formerly a legal resident of ~~~ag0
(City) (State)
and ~ resided ~r ~03 ~3~ d~°ng~- However I have changed my dor,iic,ile
(Street and Number)
to and am and have been a bona fide resident of the S±ate of Florida since 2 . day of
I7ec ember fr 5 G ene x~a7. Del i~rery
- , 19_ , and I reside at _ _ _ _ _ -
(Street and Number)
F4RY PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be take~ as my declaration of citizenship, actual legal residente and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinyuishment of employment
at former dornicils, remova{ of fan~ily to new domicile, purthese of hams, etc.)
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Entering Il~n Sxid~ralc~ in 12th Grade ,
ED
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, - ~:~~;~;~.~~~c,~~CO~y'Y,
SY• FLpRIDA
I FURTMER CERTIFY that I wili comp!y with all other requirements of a legal resident nf this 5tate.
I FURTFiER CERTIFY that I have no intention to return fo my forme~ domic,ile, and I intend ta remain in FURT
PIERCE, SAINT LIiCIE COJNl'Y, F! ORIJA, permanently.
~
~ d~~~Z:e=!r-e
. (Name)
. Fe7.iz 9vdderak~'
' ~ - _
~ {Address)
~ 2 Tfec~ber 6~
, Sr,vorr~,lo'and subscr~bed before me this day of , 19 .
_ ,
ROC'iER POIYRAS -
CtERK CIRCtJ COUR7 Notary Publit '
g - D.C. My Commission expires
Y
~ (To be executed in duplicate and original filed with Clerk Circuit Court, and duplicaf~ e~th Tax Ass~:s;or.)
aooK ~.32 274
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