HomeMy WebLinkAbout0549 D~cia~ation ot Domicil• and Citizenshlp ~
TO THE STATE AND COUNTY TAX ASSESSOR, 151863
S1. U1CIE COUNTY, FLORIDA:
Thls is my d~clar.ation of Oomicile and Citizenship in ths Stats of Florida that I sm filin~ this day in aooordanoe a~d
in aonformiry with Chapt~~ 224. Ssction 222.17, Floride Statutes.
i was fornkrly a Ipal residsnt of oirginia Beach YiY'8i~a
(City) (Stats)
and I rssidsd at ~96~ ?thena Blvd~ ~Wev~r 1 have chanqec! my domidl~
(St~~t and Number)
to and am and have be~n a bona fids resident of the Sta» of Florida since 17~ del? of
December , 19b6-. end I rosid~ et 1~ ~O~ Port St.~cie
~ (St~t and Numb~r)
l~ORT M~C~, fA1NT LtICI! COIJNTY, RORIDA
and this staMrr~ent i~ to b~ tsk~n as my declarotion of citizenship, actual le9al residence and domicile in the Stele of Horida.
p~uen here any pe~tinent fach, such as sale of property or business, or relinqui:hme~t of employmant
et formK domkile, removal of family to new domicile, purchase of home, etc.)
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$stablishing residence ~
~ R~~o aNO RECO '
App~ying for ho~eatead gT• WCIE COUN7'Y~i~~,`' ~
RECORO VERIFl~O
151863
'~l ~UI t 3 PM !2 : 36
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ROGER POITRAS
CLERK CIRCUIT COURT'
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, I FURTHER CHtTIFY that 1 will aompiy with afl othK nquiremenh of • la~al ~id~nt of thi: Stah.
~,I~1q~~l.`~tTl~lf that I have no intention ro retum to my former domiale, and I intend to remsin in FORT
pi~lt~~~`, ~ .E~~~QUNTY FIORIDA permenently.
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~ Sworn b end subscribed befom rne this ~th day of J~~~ , 19~.
ROOtR '011'R/?f
CIRCUiT tO11RT Notary Publk
Q-~~ D.C. My Commitsion expins
lT~ il~ ~ ie ~i~lit~h anr ~eiMwal lil«i wMl~ Cl~k Cit+ttiil C«wt, a~~i ~+~Iio~N wM~ T~c A~ra
~ooK 164 ~ 54r1
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