HomeMy WebLinkAbout0702 D~aiuation o~t Domiall~ and Citls~nsl~
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TO THE STATE ANO COUNTY TAX ~~SSESSOR, -
ST. WCIE GOUNTY. ROitiDA: ~ "
Th1s is my decla~atlon of Domicile and Citi~»~hip i~ tM St~h of Florida that 1 am Hlinp fhis day in aooordana ~nd
in oonformity with Chaph? 271. S~ction 242.17, Florida Statutas. .
1 was to~merly s leqal rosicl~nt of Hig~ Po~nt ~to~h aro~'in~
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and I resWed at 1003 ~~idhland Ais Hovwver 1 hsw dHrp~c! mY alomtdl~
(Stn~t and Numl~)
ro and am and haw baen a bona fide raid~nt of thi Stai~ of Fiorida sinoe ~rd day d
K~ t967 , and t~ide at 311 lTorth 12th Street
(StnN and Numbsr) _
EORT WQii~, iAM1T LUG! C0t1MY. ROR~A
and this staternent is ro be tak~n as my dedaration of citizenship, actuai Ipal residena and domidl~ in the Sta» of Horicl~.
qnsen h~m any pertinent facts, such ~ sale of prop~rty or business, or nltnquishment of ~mpioym~nt
at former domidle, amoval of family to ~w domkile, purchas~ of hane, etc.) -
- Sntering Beatri~cs I~ye~ra.~n,~he bt,h grads
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ST•aEC RD VERiFtE~
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1 RIRTHER CERTIFY that I have no intention to retum to my former domic~le, and I inte~d to rema~in in FORT
PlERCE. SAINT UKIE. CQUNT1f, FLORIDA, perma~enHy.
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Swor~ to and wbsaibsd before me this
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By O.G. My Commission expires
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