HomeMy WebLinkAbout0782 Deciaratlon ot OoMicile and CIlize~shlp
TO THE STATE AND COUNTY TAX ASSESSOR, 152~30 '
S7. WCIE COUNTY, FIORIDA:
This is my declaration of Domicite an~ Gitisen:hip in the State of Florida that ! em filinp this day in aao~~dance and
~n conformity with Chspter 222, Section 22Z.17, Florida Statutes.
i was formerly a legal resident of Buf~~l o ~Iev Yo2`k
Kiy) (Sta»)
and I resided at 4998 A~estnnt Ridge I~ad- Orchax~d P~'k - . Flcwever 1 have charpec! my domiute
(Street and Number)
to and am and have been a bona fide resident of the Stats of Florids sinae 19~ day of
- J~~~ . 196~_, and I reside at 2793 Mornin~s d i)rt v~
(Street and Number)
FORT PIERCE, SAINT lUC1E COUNTY, RORIDA
and this statement is to be taken as my decla~ation of citizenship, actuai legat residenos and domicile in ths Staro of Horida. ~
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicife, purchase of home, etc.) -
Fhtering txo children in achool
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sT.REC~a v~a~30 `
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1 fURTHER CERTIFY that I wilf aompfy with all other requlremenh of a leQal resident of this State. ~
t FURTHER CERTIFY that I have no intention to retum to my former domiyle, and I intend to remain in FQRT
PlERCE, SA1NT LUCIE C011NTY, FLORIDA, permane~tly.
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: _ ~ ' , - - 1~ili~ F . Iiiller
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Sworn to and sUbscribed befo~e me this 2~ day of JBnaLYrv , ~q~, ;
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ROGER POIT~AS j
CIRCUR OUR? Natary Public E
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BY ~~"G D.C. My Gommiuion expires i
Ro b~ ~oacuhd ie d+rpliesh and ori~insl fil~d whb Cl~ek qra~f Carrf, and duplieafr witb Tax As~tsora ;
saoK164 P~ 7i9 f
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