HomeMy WebLinkAbout2194 Declaratio~ ot Don~icile and Cit~ze~ship 14'7302
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE ~OUNTY, FIORIDA:
This is my detlaration of Oomicile and Citizenship in the State of Florida that I am filing this day in aaordance and
in conformity with Chapter 242, Settion ?22.17, Florida Statutes. ~
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1 was formerly a legal ~esident of ____~;jtRL_ ,
(Ciry) (Stets) #
and 1 resided at ~!6~9 S~reEfOrd ~ve• ~wever I have changed my domiCile
(Streei and Number) ~
ro and am and have been a bona fide ~esident of the State of Florida si~ce _______._~4tb day of
J~ A , l~ and I reside at 21.6 Sou~he7cb ~ve.
(Street and Numbe~)
FORT PIERCE, SAINT IUGIE COUNTY, FIORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence a~d domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of emptoyment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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1 FURTHER ~ERTIFY that I will comply with all other requirements of a legal resident of thia State.
1 FURTHER CERTtFY that 1 have no intention to retu~n to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_
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C~IQdXci~~.~ihd subscribed before me this lst day of ~~u~ , 19-f~
ER PC~TRAS
CIItCU1T OURT Notary Public
g ~ D.C. My Commission expires
Ro b~ ~xecvt~d in duplicaM sod ori~in~i filed with Gerk Cir~cuit Court, and duplicat~ with Tax Ast~sso?.)
aQOK 151 393
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