HomeMy WebLinkAbout0457 ~ ~ ~~~7
Decla~ation ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR.
Sl. UKIE GOUNTY, FLORIDA: ~
This is my decla~ation of Domicile and Citi=en:hip in the State of Florida that 1 am filing this day in aooordanos and
in oo~?formiy with Chapter 224, Section 222.17, Florida Statutes.
I was forme~ly a legal ~esident of sarilie ~QM YOt~
(City) (State)
and 1 resided at 2781t311Q D=~~'! . Hcwever 1 have chanyed my domiCile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since AP=il ~a day ot
, 19 69, and I reside at 121 Ri0 Mit COUSt ~
(Sheet and Number) ~
FORT PI~CE, SAINT LUCIE COUNTY, RORIOA
and this statement is to be taken as my declaration of citizenship, actual legal residenoe and domicile in the State of Florida.
(Insert he~e 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.)
Bstabliahiog residency and eaterins cbild in public achool
Richard~ Donna, Larry,Lauri~ ~ Robert Lsurito
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1 fURTHER CERTIFY that I will aomply with all other requirements of a le~al resident of this S"~te.
1 FURTHER CERTIFY that I have n~: intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORID/,, permanently.
~ (Name) Car01 ~uZ'it0
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Sworn to end subscribed before me tKis lit day of , 19 69 ~
;
~ ROaER MITRAi ~
~ CL~K QU~T Notary Public ~
~ gy r. _ D.C. My ~ommission expires ~
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