HomeMy WebLinkAbout2623 147'SU6
DeCla~ation ot DomiCile a~d Citize~ship
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TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FIORIDA: ,
This is my declaration of ~omicile and Citizenship in the State of Florida that 1 am filing this day in scoordance and
in oonfo?mity with Chapter 222, Section 222.17, Florida Statutes.
1 was fo~merly a legal resident of Teli~•
(City) (State)
5~t j E1a~1'ie Drioe However 1 have cha m domidle
and I resided at - Y
(Street and Number)
to and am and have been a bona fide ~esident of the State of Florida since _ day of
_ ~Ilgn,Qt , 1~-. and 1 reside at ~2 ~~~a A~•s
(Street and Number)
FORT PI~CE, SAINT LUCIE COUNTY, RORIDA i
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the Stste of Horida.
(Insert here any pe~tinent fads, such as sale of property or business, or relinquishment of empbyment
at former domicile, removal of family to new domicile, purchase of home, etc.) .
8atabliahing reaidence and entering child in a chool
RILEO AND RE~R~~!'. -
~T' LECOaO VER F .
R
2 : Oz
; '6~ AUG 9 4 506
1
~ FtOGER 'OITRAS
~ CLERK CIRCUIT CBURT
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I FURTHER CERTIFY that I will comply with all other requirements of a(e~al resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and I intend to re ain in RT
:
PIERCE, SAlNT LIJ~E,CAUNTY, FLORIDA, permanently.
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VSworn ta ~nd subxribed before me this day of ~~t , 19~~.
ROGER ~OITRAS
CIRCUIT COURT Notary Public ~
g D.C. My Gommission expires
Y
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(To b~ ~x~arted in dupliuN and oripinsl Rl~d with C{~ek Cirarit Cour~, and duplicaf~ witt~ Tax A~ssor.)
aooK 152 222
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