HomeMy WebLinkAbout1488 Decl~ration of Domicile and Citizenship , ~
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7~ THE STATE AND COUNTY TAX ASSES~OR,
51. LUCIE COUNTY, FLORlDA:
This is my declaration of Dorniciie and Citizenship in the State ot Florida that I am filing this day in accordance and
in conformity with Chapter 222, Settion 222.17, Florida Statutes.
I was former~y a legal resident of ~~~On _~Q1L_J~~__-
(City) (Stete)
219 Narrison Arvnne
and I resided at . _ . _ _ _ _ _ . _ _ . _ _ However ~ have changed my dami~,ile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since _ _ day ot
' DeCeRbex' , 19_ and I reside at . ~2 ,verxi!!_ F~_ Ci$y _ _
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declar~tion of citizenship, actuai legal residence and domicile +n the State of Florida.
(Insert hare any pertinent facts, such as sale of property or bus+ness, or relinquishment of employment
~ at former damicile, remaval of family to new domicile, purchase af home, stc.)
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Entering Ke~vi.a Krng in ~iid Cr~de
" Loretta Krag in lst Gr~nde
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;.,:~E _ . a "r~:~.;~. CLER
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t,~`~~-~~~ ~ S~ LUC1E ~UNTY~
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. FL
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I FURTHER CERTi~Y that I will comply with a!! other requirements o# a legal resident of this State.
I FURTHER CERTIFY that I have no intention ta ret~rn to my former domiGile, and I intend ?o remain in FOR7
PIERCE, SAINT LUC?E.,C~UNTY, FLORIDA, permanently.
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~ " ~ " (Name)
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? Sworn to 'and subscribed before me this _____-16 day of ~~ber q~,
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' ltOGER POl7ttA5 _
~ RK C1R IT CaURT Notary Public
By D.C. My Commission expires
(Ta bs exscutsd in duplicate and originsl filed with CI~?k Cirtvit CouH, and dupiicst~ with Tax atseswr.)
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