HomeMy WebLinkAbout2745 ~ U ~ ~rai I,
Decla~atlon of Domicile and Cittse~ship
TO THE STATE AND COUNTY TAX ASSESSOR,
Si. LUCIE COUNTY, FIORIDA;
This is my declaration of Oomicile and Citizenship in ths State of Florida that 1 am filing this day in aooordanoe and
in confo~mity with Chapter 222, Section 222.17, Florida Statutes.
1 was fo?merly a legal resident of ~diand Texas
K~tY) (State)
and 1 ~esided at _ 33Q7~,s.]~(at , However 1 have changed my domic}le
(Street and Numbe~j
to a~d am and have been a bona fide resident of the State of Florida sinoe alat day of
Ar,r; t , 19~Q, and 1 reside at _ Bnut~ 1 Be~c SS~
(St~eet and Numbef) .
fORf PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be take~ as my dectaration of citizenship, actuat lega) res+dence and domicile in the Siate of Horlda.
(Insert here any pertinent facts, such as sale of property or business, or_ relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bstabliah residency
FILED AN~ REC~R~E~.
gT, LUCIE COURIF EO A.
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~69 APR Z i PN 3• ZZ~ .
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~,p~r;• , 01SRAS
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I FURTHER CfRTIFY that I wiii oompiy with all other requirements of a lega) tesident of this State.
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1 FURTHER CERTIFY that I have no intention to retum to my former domiGle, and 1 intend to remain in FORT `i
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PIERCE, SAINT LUCIE COUN?Y, FLORIDA, permanently.
/ ~
~ (Name ~ J, St.Gessaist ~ Jr.
(Address)
Swom to and suburibed before me this ~;st day of __Anril ~q~Q,
.
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,TRAS~~
Notary Publk
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8Y t D.C. M
y Commiss'wn expires
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~~~aiNd,~j and orioinal Bl~d whh Cl~rk qrwit Carr~, and duplleaf~ wi~h Tax Aaa~.)
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