HomeMy WebLinkAbout2012 i
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Declaratio~ ot Domicile and Citizenship ,
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TO THE STATE AND COUNTY TAX ASSESSOR, E
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Si. WCIE COUNTY, FLORIOA: '
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This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in aooordance and
in conformity with Chapter 222, Section ?22.17, Florida Statutes.
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1 was formerly a legal resident of Beaver Fella P enn. '
(Ciy) (Stste)
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and I resided at __2812 5th AVeALte . Ho`wever 1 hsve cF~nged my domivle
(Streat and Number)
to and am and have been a bona fide resident of the State of Florida since December day of '
~yo /1
,~9 68, e~d i~es~de at 60? ~3r Avenue
(Street and Number) ,
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FORT PIERCE, SAINT WCIE COUNTY, FLORIDA '
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and this statement is to be taken as my declaration of citizenship, actual lega) residence and domicile in ths State of Horida.
(Insert here any pertinent facts, suth as sale of property or busineu, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
For homestead purposes
F~LEO AND RECOROEp
ST. LUCIE COUNTY, F~~.
j~' COa~ ,~`~tFIEp
1~'45~;~ ~
'6~ FEB 7 Aal 9: 2y
' RO:,ER r ITR.:S
~ CLERK CIR~V~r COURT
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1 R1(~TkfER CERTIFY that 1 will oomply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to ~etum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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(N e) ncent D. Formichella
(Address)
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Swom tQ and subscribed before me this ?th day of February , 19 69
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. ' R.OGER `~bITRAS
; d,ERK CtRLUIT COURT Notary Public
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8y ' : ~ . , D.C. My Commission expires
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(To b~ ~x~cut~d in dupliut~ and oripinal filed witb Cl~rlc Cirait Court, and duplicat~ wHh Tax Ass~stor.)
$oax i~'15 2~t1~
No. 13 .
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