HomeMy WebLinkAbout0998 Declaration ot DomiCile and Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR, i64023
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Sl. LUCIE COUNTY, FLORIDA:
This is my detlaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17. Florida Statutes.
I was formerly a legal resident of ~R~~~-. '~ISCON3I~
(City) (Stab)
and I resided at OoO~e~c Road However I have changed my domiti~e ~
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since _ 18t day of
ber 6 ~ 1 reside at 801 Quincey Avenue, Fort Pieroe, ~a. ~
--~QY~~ - - - 19 a d
(Street and Number) `
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be take~ as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) ~
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Ho~sT~w pvarosBS .
FIlEO AND RECOROfi01
ST. l.UC1E COUNTY. RLA:'
RECORD VERIFI~D
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ROvER t~0f7RAS ~
CLERK CIRCUIT COURT_
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~ 1 FURTHER ~HtTIFY ihat I wil) oomply with all other requirements of a legal resident of this State.
~ r rn t m former domi 'le and I intend to remain in FORT
I FURTHER CERTIFY that I have no ~ntention to etu o y G, ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ ~yv~~to=a'n~`si~aibed.before me this l8t day of Februar
s~ /ii; . : £ ~.s `
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~ ROGER POITRAS _
~ C CIRCUR COURT ~ Notary Public
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J gy D.C. My Commission expires :
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(To b~ ~x~cvNd in dupliut~ and original filed with CIKIc Grcuit Cour~, and duplica» with Tax Ass~ssor.)
~a~ smK 17U P~~E y95
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