HomeMy WebLinkAbout2011 . . . lfi~s
. . O~alaratio~ of Danicil~ and ~Citis~~ship
TO THE STATE AND COUNTY TAX A.SSESSOR, • ~
Sl. LUCtE ~OUNTY, FIORIDA:
This i: my dscis~ation of Oomicile and Citiz~nihip in tht Stat~ of Horida that 1 am fllin~ this day in aooordano~ and
in oonformiy with Chapter 22Z. Settion 222.17. Florida Statut~s. ~
I wa: formtrly a le~al rosid~nt of 8tat~II I~l~d ~Ow ~QrY •
(C1M tSts»?
and i msided st ~ 3922 Riohuond A~~nus . Howw.r i haw chuq.d rny domW1.
(StreN and NumbK)
ro and am end have been a bona fide rosid~nt of tM Stat~ of Florida sina 20th day of
Sento,bsr , t9~, snd ~ ro~ide r 113 Sola~ ~sn •
, (Street and Number) -
fORT MERCE, SAINT LUCIE COUNTY. l~LORIDA '
and thi: itatsrr~ent-is to be taken as my deda~ation of citi~n~hip, actud Ipal residenw and domicil~ in ths State of ~ida.
pnsert hen any pe~tinent fads, :uch as sale of propsrty or bu:ineu, or relinquiahm~nt of employm~+t
st form~r domkile, removal of family to n~w domidte, purthsse of hom~, etc.) _ ~
$etablish Bseidsnoy
Il.EO ANO REC,O~Y~~~ -
~ vVN ~1,A.
g , I.UC~E ~ tED _ _
RF C~6t~
i 1 10~ 20
; '61~-OCt 13 ~ -
~
6 i.0_~i.*~ i 0?1 COUR
~L~RK CIRCU~T
1 RJRTHER Cf~TIFY fhat I will oompiy with ~Ii other t~quire~r~snts of a Ipal ~ident of this Stah.
1 FURTHER CERTlFY that I have no intention to retum to my former domitjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE ~OUNTY, FLORI~A, permanently.
~
.
~ (Name) _
l~els_Vlotor
r~s)
Sworn to and wbsaibsd before me this 13th ~y ~ OQtnt~er , 19_fi?
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: ~K C~ COtlRT ~ Notary Public
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g~ . . O.C. My Commissan ucpin~s _
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