HomeMy WebLinkAbout0131 169~13
Deciar~tion ot Dore~icile and Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR, . ~
Sl, IUCiE COUNTY, FIORIDA;
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This is my declaration of Oomicile and Citizenship in the State of Florida that I am filir~q this day in aooordanos and
in oonfo~mity with Chapter 222, Section 222.17, Florida Statutes. ~
T80? YIOH ' ~
I was formerly a legal resident of
~~ity~ (State)
201 I,eSdele . However 1 have chanyed my domiCile -
and I resided at
t
(Street and Number)
ro and am and.have been a bona fide resident of the State of Florida sinoe 15th day of
Jul3t . , 1~8 , and I reside at 102 I3.P~ciIDa VietB Blvd.
(Street and Number) ~
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my decla~ation of citizenship, actual legal residence and domicile in the State of Horida.
(tnsert here any pertinent fads, such as sale of property or busineu, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
' $NTERING CHILD IN PUBI,IC SCHOOI~
,
~I,LY AN8 TAYIAB ~6 yre ~
~~li.~~ I!?i~lU #tE~ORDEO
S~. LUC~~ ~D~~TY, FLA~
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-~ss~is .
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~se au~ 7~? i i: 3 0
:i~ t• ~~~ITfRt.S
CLEaK CIRCUIT COURT
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1 FURTHER GERTIFY that I will oomply with all other requirements of a(e~al'resident of this State. ~
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1 FURTHER CERTIFY that I have no intention to return y forme~ domicjle, and I intend to remain in FORT }
i
~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
~ ~
(Name) i
. JOH~T D. TAYIAE ~
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• ~G ' (Address)
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: : ~ a ~ ' _ 7 th ~IIGII3T 68
~:~r~`~'""ri tE~and~~bscri~ied before me this day of , 19 . t
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~ CUIT URT Notary Public
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gy D.C. My Commission expi~es ~
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(To be execufed in duplicai~ and originsl filed with Clerk G~wit Court, s~d dupfiea» with Taat llssfssora ~
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