HomeMy WebLinkAbout1769 Declaratlo~ ot Domicile and Cittzenship 1 ~,8~$9
TO THE STATE AND COUNTY TAX ASS~SSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that I am filing this day in atoc~dar?ce and
~n confo~miy with Chapter 22?, Section 224.17, Florida Statutes.
1 was formerly a legal resident of enrv _ ~ 1 _
~C;y~ (Staro)
and 1 resided at -~'.~12 AIIYIe Street However 1 have changed my domiG~e
- - (Street and Numbe~)
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to and am and have been a bona fide resident of the State of Florida since day of ~
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.Iut1e___ , 19~$, and I reside at 475 Abeto I~a11e
(Street and Number)
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FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actval legal resi~ence and domicile in the State of Horida. '
(Insert he~e any pertine~t facts, such as sale of properiy or business, or relinquishment of employment ~
at forme~ domicile, removal of family to new domicile, purchase of home, etc.)
Tstablishing residence and will enter children in Public
school STILED AND RECORD ~
E
C~~RD
~URi7YE LA.
'6B JUL 5 1~8~8~
PN ~;51
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CLERK CIRCUj TRaS
i T COURT
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1 FURTHER CERTIFY that I will comply with all other requiremenis of a le~al resident of thi: State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT :
i
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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1;~= (Name) ;
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~ , `Gvi 1 - CO,',/, t
~ ; y~ t j~G : : Aorman Behl ~
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~ ~~~a~~ d??3d.wbxribed before me this th day of Jul , 19
~r.,~:.;,:,. 5 :
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Roo~e romus -
CIRCUIT COURT Notary Public
By - O.C. My Commission expires
(T~ b~ ~ncrNd ie drplicat~ and aioinal Al~d wiTh CIKIc Ciiari! CarN, anr duplical~ with Tax A~a~.)
a~i?2 F~fi762 ~
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