HomeMy WebLinkAbout1232 Declaratlon ot Dor~ictte aad C141zenship ~
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TO THE STATE AND COUNTY TAX ASSESSOR, '
5~. IUCiE COUN'iY, FIORI~A: ~
This is my declaration of DAmicile and Citisen:hip in the State of Fiorida that 1 am filinq this day tn aco~rdanoe and
in confornn~ty with Chapter ~22, Seclion 222.17, Florida Statutes.
! was formerly a legal resident of 8elet ~ii0
Kity) (Stata)
and 1 resided at ~98 NO. Roc~Jr Ri~t= Dt31?e 1~Iowever i have charped my domFdla
(Street and Numher)
to at~d am and have been a bona fide resident of the Stats of Flarida sfnte ~~e~~s ~ day of
~9~$_, and t reside at 1024 Cit~cus A~enue
(Stre~t arul Numb~r)
EORT PIERCE, SAINT LUCIE COUNYY, FLORIDA
and, this statement is to be taken a: my decta~ation of citizenship, sctuat lega) ~esidenoe ar~d domldle in ths State ot Horids.
(lnsert here any pertinent fads, such as sals of p~operty o~ twsiness, or ~ellnquishment of employment
- at form~ domicite, remova! of family to ~ew domicile, purchase of home, etc.)
for hoveatead purposea
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, . 1 FURTHER CERTIFY that 1 will comply with all other requirements of a leyal ~esider~t of this State.
I FURTHER CERTIFY thaT I have no intention to retum to my former domiGle, and 1 intend to remain in FOR7
PIERCE, SAINT LUCIE COUNTY, FLORtDA, permanently.
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(Na ) lindp Stirnet
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~~`t ~'~?i~~~t~ snd subsuibed before me this day of
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, ~'~017RAS
~'.••.'k• ~ CIRCUIT COUR7 Notary PuWtc ,
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6y ~ D.C. My Commission expiret
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(To be exewted in duptiat~ and ori~inaf fil
~ t}~ Clerk Cjrruit Cour~, and dupljcst~ wlth Tax Asssssora
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