HomeMy WebLinkAbout0623 Declaration ot Domicile and Citisenship
163'788
TO TNE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORtDA: `
rdanoe and ~
This is my declaration of Uomicile and Citizenship in the State of Florida that I am f~l~ng this day in acco
~n conformity with Chapte~ 222, Settion 222.17, Florida Statutes.
I was formerly a(ega) resident of CBn~Ot1 _ Oh10 _ ;
~C~ty~ (State) ;
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and 1 resided at _ 3_ 825 Cleveland Ave. S. ~~,,,ever 1 have changed my domi~ile
(Street and Number) _ '
ro and am and have been a bona fide resident of the State of Florida since day of
AgSl~__ t9
66_, and 1 reside at 1919 Wyomin~ Ave.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA .
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establishing residence F~LEO AND RECOROED
ST. LUCIE COUNTY, F~q,
N:~COR~ V~RIFIED
163'~8g
'se JAN 24 AM I I; p
Fit"'.~L--~< 'O~T ~ ~
CL.ERK CIRCUIT COURT
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I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
~ 1 FURTHER. CE(tjIFY that I have no intention to return to my former domiu~e, and I intend to remain in FORT
.~sitr~;`:; -
PIERCE, SA~M~~.~EIE~OC~~NTY~,FLORIDA, permanently. j
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~ 24th January b8
Y~ Sworn to and subscribed before me this day of . 19 •
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~ ROGER POITRAS
~ K CIRCUIT COURT Notary Public
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~ g D.C. My Commission expires _
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(To b~ ~x~cut~d in dupliub and ori~inal filsd with Cl~rlc Urcuh Court, and dupliut~ with Tax Ass~stor.) '
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