HomeMy WebLinkAbout2104 ~eclaration ot Domicils and Citisenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
Si. UlCIE COUNTY, FIORIDA: ~
This is my declaration of Domicile and ~itizenship in the State of Florida that 1 am filin~ thi= day in acoo~dar~oe and
in conformity with Chapter 222, Section 222.17, Flarida Stetutes. ~
I was formerly a legal resident of W> > dwood Npw ,jc+rspv
tCiy) (St~ro)
end I ~esided at _ 118 Bast 14t h St reet , However I have chanyed my domidle
(Street and Numbe~)
ro and am a~d have been a bona fide resident of the Stste of Florida sinte 18th day of
Februarv , tq 6? , and I reside at 1917 So 34th
(Street and Number) ~
FORT l~IERCE, SAINT LUCIE COIINTY, RORIOA
and this statement is to be taken es my declaration of citizenship, actual leflal re=idence and domicile in the State of Florida. `
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(Insert here any pertinent facts, such as sale of property or busineu, or rolinquishment of employment
at former domicile, removal of family to new domicile, purchsse of home, etc.)
E FILED AND RLCORDEp~ ~
ntering children in school ~
ST. LUCIE COUNTY~
' RECORD VERIFIEO
~stablishing residence 15 !g~g ;
~ fEB 20 9 ;
-~_°-~v : o ~
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ROG~H rOtTRAS ~
CLERK CIRCUIT COURT ~
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1 FURTHER CERTIFY that I will oomply with all other rsquiremenri of a le~a) resldent of this State.
1 FURTHER CERTIFY that I have no intention to retum to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE~COUWTY, FLORIDA, permanently.
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- - - ' ~ Dolores aricks
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Sworn to and subscribed before me this 2 Oth day of Fehriiar~-, 19~L~-
ROGER POITRAS
CIRCUIT C URT Notary Public
gy D.C. My Gommission expires
(To b~ ~ucvl~d in duplicst~ and ori~inal Al~d with C{~ek Cira~it Couet, snd duplicab with Tax Ass~or.)
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