HomeMy WebLinkAbout2586 Declaration ot Domicile and Citizensh~p
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TO THE STATE AND COUNTY TAX ASSESSOR, 4
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Sl. IUCIE COUNTY, FLORIDA: j
This is my declaration of Oomicile and ~itizenship i~ the State of Florida that 1 am filing this day in aooo~dsnos and
~n conformity with Chapte~ 222, Section 222.17, Florida Statutes.
1 was forme~ly a legal resident of Sout~erntoii COl71?•
(Ciy) (State)
and I resided at _ 5~ K~berry St~eet ~wever 1 have chanyed my domiSile
(Straet and Number)
to and am and have been a bona fide resident of the State of Florida since 3~ day of
-a~Y_ ~ . 19b?,, and 1 reside at ~ 3 Bo7c 2g7 B
(Sheet and Number)
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FORT PiERCE, SAINT lUC1E COUNTY, FLORIDA '
and this statement is to be taken as my declaration of citizenship, attual tegal residence and domidls in the State of Hotida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employm~nt
at former domicile, removal of family to new domicile, purchase of horree, etc.)
Sntering I~nda in Jr Hi~
,
~ Darrell in 5th grade F~LED AND RECORpFp ~
ST. LUCIE COUNTY, F~, ~
" Kargaret i.n the l~th grade RECORD V~R~F~ED
N &ixard in the 3~ ~'ade '~59~~
~'6T AUG 23 PM I: 51 i
, ,C~~ar.~~
fiOti~R r01TRrS . `
CLERK CIRCUIT COURT
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I FURTHER CERTIFY that 1 will oomply with all other requiremerlts of a le~al resident of this State. ;
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I FURTHER CERTIFY ihat I have no intention to retum to my former domicjle, and 1 intend to remain in FORT {
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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Swott~ to~ and subscribed before me this 23~ day of l~~t , 19~_.
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ROG~ rO1TRA5
CLERK CiRCUR COURT Notary Public
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g D.C. My ~ommiuion expires
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(To b~ ex~aMrd in dupllcab and oripinal RI~1 f~ Sirarit Cov~f, and duplicaN with Tax Ass~or.)
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