HomeMy WebLinkAbout0854 .~s~sss
Declaration ot Domicile a~d Cittzenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in ths State of Florida that I am filing this day in acoordance and
in conformity with Chapter 222, Section 222.17, Flo~ida Statutes.
I was fo~merly a legal ~esident of ~~~e pA~~~~~lvaaia
(City) (Stats)
.
and 1 ~esided at __~_~GO.~-t.._AY$.ri~@ . However 1 have changerl my domiCi~e
(Sheet and Numbe~)
to and am and have been a bona fide ~esident of the State of Florida since day of
nRremhe , 19~_, and I reside at Cgusev~av TrAi 7 er Qo ~Lt ~ 601 Siawav DT.
(Street and Number)
fORT MERCE, SAINT LUCiE COUNTY, FLORIDA
and this statemez~ is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Ho~ida.
(Insert here any pertinent fads, such as s.ale of property or businessr ~+r relinquishment of employment i
at former domicile, removal of family to new domicile, purchase of home, etc.) i
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Establish reaidence ~
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~~O AND REC , -
ST. LUCIE COUNTYe~.~°
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~ 8 JUN II AM t0:3 ~
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~0;;[R ? OtTRAS
. CLERK CIRCUIT COURT
1 FURTHER CERTIFY that 1 will oomply with all other rsquiremenls of a leyal residsnt of this State.
1 FURTHER CERTIfY that I have no intention to return to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
(Neme) 1Pi iam H. Hoffman
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Sworn to and wbscribed before me this day of ,jl~na , 19..F$_.
C~~JCM~Wt, COI~s- Notary Public
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ay ` My COf11f1~iss10~1 lXPifAt
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