HomeMy WebLinkAbout2010 D~cla~aUon ot Domicil• and Citisenship 16~55
TO THE STATE AND COUNTY TAX ASSESSOR, ,
Sl. LUCIE COUNTY, FLORIOA:
This is my decla~ation of Domicile and Citizenihip in th~ Stat~ of Florida that 1~m filin~ this day in aaoo~danw and
in oonformity with Chapter ~22, Settion 222.17, Hotida Statut~s.
I was formKly a leqal resident of $~L~ ~s8IS8I~YI
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and I residsd at _a0ut~ ~ 3 . I~bvwvK 1 hav~ tharp~d my domWl~
(Str~t and Number) ~
ro and am and have been a bona fide nstde~t of ths State of Florida :inos ~'~t~ ~Y ~
8~ptsaber 1967 . and i~we a~ ~t 3 Bo= 490 ~ -
~ and NumbK)
FORT tIBCE, SAINT lUC1E COUNTY. RORtOA
and thi: atatement is to be tsken ss my declaration of citi~e~ship, actual Ia9al residena and domicile in fhe Stat~ of Horida.
qnse~t hero any pertinent fact:, :uch a: sale of prapsrty or businsss, or rolinqul~~t of employm~nt -
at former domicile, removal of family to n~w domidle, pu~d~ass of home, sfc.)
Brltsring ohildron in eohool
. FI~EO ANO RECOROED
ST, lUC1E COUNTY. FLA,
Suean Orus and Yioki in SleaeatarT R~CO~iV~sr~
t~V ~j
~o~si J ana ~a D~e in Jr. si~ 'sl OCt 13 AM g; SS
e
Dsiinaa in Hs~ aohooi ~oti~ R~OITR~S
CLERK CIRCUIT COURT
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€ 1 Ft1R~ .~IFY that 1 will oomaly with all olhsr roquirerrient: ot a lepal resident of this State. _
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, ~~`:1N1~a~:rr~r;';,'~
~Et~~RT1fY that I have no intention to retum to my former domiUle, ond ! intend to rem~in in FORT
~a... • c~,, . . -
PIEI~~~jl~t~•~~J~I~~C-.t~1F;~ RQRIDA, permanently.
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• . . . . • • - (A~ddress)
Sworn ro a~d subsaibed before me this 13~h ~y ~ OOtObar ~ ~9 't .
ROGER rOfT~Ai .
p~ERIC CIRCWT COURT Notary Public
gy D.C. My C«nmiu~on expims
Re b~ aoaaiNd in dupiicaN and o~i~aai t~d whh Cl~ic Ciee~it Cou~t, and d~plicaN wi1l~ Taoc As~a~e+~a
dppK1,V~ P1~E~~
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