HomeMy WebLinkAbout2010 Ooclaratio~ o! Oumicile and Clti:~nship ~
TO THE STATE AND COUNTY TAX ASSESSOR. 1455~0
Sl. IUCIE GOUNTY, flOR1~A:
.
This is my declaration of Domicite and Citi=enship in the State of Florida that 1 am filin~ this day in aaordsnos and
in oonformiy with Chapter 222, Section 222.17, Florida Statutea.
I was formerly a legal ~esident of ~~~'~'~J
(Ciiy) (State)
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and 1 ~esided at ~ ~ However i have chan~ad my domidle
(Street and Number)
to and am and have been a bona fide resident of the State of florida since day of
_ , 19'O ~ , and I ~eside at
raet and Number)
IrORT r1ERCE, SAINT tUC1E COUNTY, FLORIDA
and this statement is to be taken as my daclaration of citizenship, actual legal residenoe and domicils in the State of Florida.
(Insert here any pertinent facts, such as mle of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
iuE cov~~~'
- . '~ECORO vERIFI~~ ~
MAY Z 58
'66 ~~Si~U
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.
ROGER ~~T COURT
C~ER~( CIRCUIT
; 1 FURTHER ~ERTIFY that 1 will oomply witfi all other requirement: of a Isyal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to retum to my ~rmer domicjle, and I intend to remain in FORT
i
PIERCE, SAlNT LUCIE COUNTY, FLORIDA, permanently.
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~ -~=~5v~ili~'~to and subscribed before me this ~ 3 day of ~ 19 ~'6
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; ROGER ~ORRAS
~ Notary Public
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~ gy D.C. My Commiulon expi~es
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~ Re b~ ~arl~d ia duplkat~ and oei~inal fil~d with CIKk Cirark Couet, and dup~ata wilh Tan AsM~xa
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