HomeMy WebLinkAbout0498 D~cla~ation ot Doml~il~ and Citis~nship ~~3~~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. UJCIE COUWTY, FLORIDA:
This is my detl~ration of Oomicile and Citits~ship in th~ State of Tlorida th~t 1 am filinp this day i~ sooordana end
in oonformlty with Chapter 2ZZ. Section 222.17, Horida Ststuhs.
~ ~o~ .
1 wa: formariy a Ipal rosid~nt of
(Ci ~~h~
and 1 rosided at ~~7CJ Hawever I have thuqsd my domidl~
(Sthet and Number)
ro and am a~d have baen a bona fide ~eiid~nt of the Staro of Florida sinae d+Y ~
' d
, 19 and I reside at
~tree~ and Number)
lORT M~CE, SAINT U~CIE COtMITY, RORI~A
and this statement is to be taken as my doclaration of ati~enship, actual layal rasidenoe and domicile in ihe Stata of Horid~.
qnsert hero am?~ pertinAr~t fads, such as ssie of properiy or business, or mlinquishment of empioymem
at former domidie, r~emoval of family to new domicile, purchase of hane, etc.)
i
FII.E~ AN ~OUNYYpFLA•
S?'AFCO~o v=RIF1ED
1?~~20
'69 ,1AN 6 PM 2: t 9
~
• iyC" R POITRAS
~~Ea CIRCUIT COURTi
f
~
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i RJRTHER CHtTIFY that 1 will oomply with all ofhsr roquiromMK of a le~al rssident of this Stste.
1 FURTHER CERTIFY that 1 have no intention to retum to my fomner domicjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORlDA, permanently.
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5Miot~j:to arld wbsaibsd before me this v` day of 19~.-
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ROOER ~OITRAS
CIRCNIT Notary Publk
By °~`'~"l~ . D.C. My Commission expires
R~ b~ ~oae~rNa iu deplieaN and eei~ fil~d will~ G«k Ci~a~if cow~, and d~plieal~ wilh Tax As~era
sO01I~~ P~ILE
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