HomeMy WebLinkAbout0617 aecla~at3on of Oorni~ile and Citt~cs~ship
TO THE STATE ANO COUNTY TAX ASSESSOR, ~4~~
51. UKiE COUNTY, PLORIDA: • y
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This is my decla~ation of Oomiule a~d Citizenship in the State of Florida that 1 am filing this day in aooordsn~e a~d
~n tonfo?mity with Chapter 222, Sectio~ 2~2.17, Flor+da Statutes.
I was formerly~ a legal . resident of '`k`'''~ - i~ Z _
. ` ~~;~y) (State)
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and 1 resided at -Y~~""'h~ ~ However I have changed my domitile
(Street and Number)
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to and am anc3 have been a bo~a fide resident of the State c~f Florida since dsy of
, 19'°~, and 1 reside ~ C~
(Street Number)
fORT PIERCE, SAINT LUCIE COUNTY, F~ORIDA
and this statement is to be taken as my detlaration of citizenship, aciual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, suth as sale of property or business, or relinquishme~t of employment
at former domicile, removal of family to new domicile, purchase of ho~e, etc.)
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Ft~~ ~fl RECORDED ~ k
ST, lt~C1E ~VERIF E
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RECOa
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~66 NOV ~ y ~ 10 • .
ROGER 'OtT COURT - -
I ~L~R~( CIRCUIT ~
1 RIRTHER G'E~TIFY that I will oomply with al) other requirements of a lega) resident of this State.
1 fURTHER ~ER~TIFY that I have no intention to retum to m o er domitile, a~xl 1 intend to remain in FORT
PfERCE, SA~[~~„LUCI~,Cc7UNTY, FLORIDA, permanently. ~
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~ Sv+ofn ta and subsc~ibed before me this day of ~G , 19 .
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~ R~ER POITRAS
~ CIRCUR COURT Notary Public
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gy D.C. My Commission expires
(To b~ ~aaM~d in du~licah snd oripinal Flsd with Cl~k Grwit ~ourt, and duplieate with Tax Ass~ssor.)
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