HomeMy WebLinkAbout1221 O~cla~ation ot Domicile s~d Citis~nship
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TO TME STATE ANO COUNTY TAX ASSESSOR,
Sl. ItJCIE COUNTY, FlOR10A:
This is my decluatio~ of Domicils ared Citis~nship in th~ State of HorWa that i am filinq this day in aooorda~cs ~nd
in oonformity with ChaptK 22Z. Settion 222.17, Florida Statut~s.
1 was formKly a Ipal rosident of .Te ~SO~e Citp New YOrk
(City) (Stab)
and t ntid~d ~t ~.,,~1,-Y~1"tl@ Averue . How~wr 1 haw thup~d my domk3l~
(Str~et and Numbsr)
ro~nd am and hav~ besn s bona fid~ resident of th~ Staro of Florida sinoe 3i"d day of
, 19~~., and 1 roside at 3501 Avenue Q ,
(Stro~t and Numbe~)
loORT MRCE. S~AMlT LUCIE COtMITY, RORqA
and this statbmsnt is to be tsken a~ my declaration of citiunship, actval leyal res'Klenos and domicile in the State of Horida.
pnaert hsrs any perti~ent fads, sucfi as sale of properry or bu:iness, or rolinquishment of emplo~yment
at formK domicite, mnaval of family to new domicile, purchase of home, etc.)
~ Entering children in public achool
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i FURTHER G~tTIFY th~t I will aomply with all oth~r roquinrrwnts of a lepd ~esid~nt of this Stste.
1 fURTHER CERTIFY that 1 have no intention to retum to my former domiale, and I inte~d to ~emaln in FORT
PIE~tCE, SAINT UKIE COUNTY, FLORIDA, permanently.
.
(Nams) 8lchard Collins
~
(~4~ddross)
Sworn a•nd subscrib~d b~fon n~ this 21 et ~y ~ Ja~vArv , 19~~.
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