HomeMy WebLinkAbout1146 Declaration ot Don~icile and Citizenship ~
17'39~84
TO THE STATE AND COUNI'Y TAX ASSESSOR,
S1. LUCIE ~OUNTY, FIORIDA:
This is my declaration of Domicile and ~itizenship in the State of Florida that 1 am filing this day in aooo~danos and
in co~fo~mity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal ~esident of BdiSOO New J,drs~_
(City) (State)
and 1 resided at 61 Wilk ROad . However 1 have cha~x~ed my domi~jle
(Shset and Number)
to end am and hsve been a bona fide ~esident of the State of Florida since ~~th _ dey of
October , 19~$, and I roside at 172 Lobstp* Rd. ~Pt. St_ Lucie
(Street and Number)
FORT r1ERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be saken as my declaratwn of citizenship, adual legal residenoe a~d domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of propery or business, o? relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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1 FURTHER CERTIFY that 1 will comply with all other requi~ements af a le~al rosident of fhis State.
1 FURTHER CERTIFY that I have no intention to retum to my former domitile, and I intend to remain in FORT
PIERCE, SAINT llK1E COUNTY, FLORIDA, permanently.
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T~HN FRAZ~_A
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~ . ` : ~ ~x 172 Lobsi~er Road, pt. St. Lucie ~
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Swor~ to and :ubscribed befo~e me this 20th day of .J~uarX , 19_~9
ROG~ rORRAS
CL~RK C~CUR COtlRT Notary Public
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gy D.C. My Commission ~xpires
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