HomeMy WebLinkAbout2146 Decla~atio~ ot Domicife a~nd Cittsenship
~ 152913
TO THE STATE AND COUNTY TAX ASSESSOR,
51. lUC1E GOUNTY, FIORiDA:
This is my declaration of Oomicile and Citizenship in the StaTe of Florida thet 1 em filin~ this ~Jay in aooordar~os and
in oonformity with Chspter 222, Section 222.17, Florids Statutes.
~ I was forme~ly a legal ~~~da,t of _ 31l~ Hn?t1sr.S~tlgatuCk l~iiChigali
(City) (Stab)
and 1 resided at 31L Bntler Strest , Howevar 1 tiave thanqsd my domicjle
(Straet and Numbe~) _ .
ro and am and have kxen a bona fide ~esident of the State of ftorida since 10t1'? day of
~p~' t 9~ 761~ Prima Vista Port St. Lucie
, , and 1 reside at ~
(St~eet and Numbery
FORT PIERCE, SAINT lUC1E COUNTY, RORIDA
and this statement is to be teken as my declaration of citizenship, actusl leflel residencs and domicile in the Stste of Horida.
(tnse~t here any pertinent facts, such a: sale of property or buslnets, o? reltnqutshment of employmsnt
at former domicile, removat of family to new domitile, purthase of horrk, atc.)
RECOROED ~
g~L~UC
E COUNTY~ F~• Eatabliah Residenay for Hoaieetead pnrposea
~,E~ORD VER1FtE0
152913 ; 54
_ ~61 FEB 2 ? 11
;~o~; ~OURT
CLERK C1RCUt~
I R1RTIiER CHtTIFY tF~at 1 will aomply with atl othsr requirements of a le~al reside~t of thts State.
I FURTHER CERTIFY that 1_have ~o intention to retum to my former domiGle, and I i~ter?d to remain in FORT
PIERCE, SAINT lUCIE COUNTY, FLORIDA, permanently.
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•}y' y~wctT,~;;~i~aubscribed before me this 2~~- day of - ~b~BI'Y i9~_.
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!trt~.pomus
- , ~''"i~ cu~cun couRr
Notary Public
BY ~.T~~~C D.C. My Commiu'wn expires
(To b~ ~c~c~M~d in duplkN~ anel o~i~inal~A~id~wifi~ Cl~k _Circuif Couet, and duplkah? wi11~ Tax Asta~or.I ~
BOOK PAGE~i42 ~
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