HomeMy WebLinkAbout0072 D~claration ot Domiclie and ~itl:enship .
~ 15~.536
TO THE STATE AND COUNTY TAX ASSESSOR,
Sj. LUCIE COUNTY. FLORIDA: . -
This is my detlaration of Oomicile and Ctizenship i~ the State of Florida that I am filin~ this day in aaoordanos a~d
in conformity with Chapter 222, Sectio~ 222.17, Florida Stafutes. ~
I was formerly a(egal ~esident of Sa7~tOD I~Ii3souri
(City) (Stah)
and 1 r~idad at 525 Colemat! . However'1 have c~a?ped my domidle
. (Street and Numbe~) ~ ~ ~
ro and am and have been a bona fide ~esident of the State of Florida sinoe 22.nd day of
~U$u3t , 19~_, and I reside at 164 Ser~n~tg '
" (Street and Number)
FORT ~I~CE, SAINT LUCIE COUNTY, fLORIDA
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and thisitatement is to be taken as my declaratwn of citizenship, actual legal residenoe and domicile in fhe State of Horida.
qnsert here any pertinent facts, such as sale of property or business, or relinquishment of empioyment
_ at formar domicile, removal of family to new domicile, purchsse of home, etc.)
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Establishing residence
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RECORp VEt~IRI~ ` ~ !
~Si535
'6t J~UII ~ AM 10 : i ~
_ ~ ~.~~ali'~,~
, ROGER PpITRqS
CIERK CIRCUiT COUI~T
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~ I FURTHER GERTIFY that I will oomply with al) other raquirements of a lepal reside~t of this State.
1 RIRTHER CERTIFY that 1 have no intention to retum to my fo~mer domicule, and I intend to remain in FORT
,
PIERCE;.SAINT LUCIE COUNTY, FLORIDA, permanently. _
_ ~~~,.?tic:i:ii7lj~r~'. ' '
y • t ~ ' ~ ~ ~ `,~'J. ~ •
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:C?~
- (Name)
~ - Lelia M Saa le
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~ ~ ~ j~?~ • ~ ~ (Address)
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5worri fo and subscribed before me this 4th day of „j anuary 19S?Z_.
RI~G~ rORRAS
CIRCUR COURT - Notary Public
gy a-`'~''~- ~~'l~ My ~ommiu'wn expires
(Te b~ ~ai1~d in duplicN~ and orioinal f~d wilh derlc U~ Couet, and dvplkaN with Tax As~a~ora
~164 ~ .72
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