HomeMy WebLinkAbout0947 Declaration ot Domicile and Citiza~ship
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TO THE STATE AND COUNTY TAX ASSESSOR, ~i
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51. IUCIE COUNTY, FLORIDA: !
This is my declarotion of ~omicile and Citizenship in the State of Florida that 1 am filin~ this day in acoordanoe and
in oonformity with Chapte~ 222, Section 222.17, Florida Statut~s.
1 was fo~merly a lega! ~esident of Thomaaville G!Olg~i
(CitY) (Sts»)
and I resided at _ ~lO bSSt walCOtt ' , FIOWever 1 have changed my domidle
(Street and Number)
to and am and hav.e been a bona fida resident of the State of Florida sinoe ~tOber 3 ~y ~
, 19~~, and I reaide at 215 r1o. 39th Street ~P.O. Bx.1~47~
(Street end Number)
FORT PIERCE, SAINT WCIE C4UNTY, ROItIDA , ~
and this statement is to be taken as my declarotion of citizenship, actual legal residenoe and domicile in the State of i~ida. ~
(Insert here any pertinent facts, such as sale of property or busineu, or relinquishment of employment
at former domicile, removal of family to new domidle, purchsse of home, etc.)
Bstabiishing residency o~p~ ;
F1LE0 aN~ RECOR !
~pUN?Y. FL.A-
ST~I2FC~ n v~RtFICO
184~Q
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~~ERK CIRCUrT CO
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I FURTHER CERTIFY that 1 will oomply with al) othar requirsmenri of s le~sl ~ssident of this State.
1 FURTHER CERTIFY that I have no intention to retum to my former domic,ile, and 1 intend to remain in FORT
PIERCE, SAINt LUCIE COUNTY, FLORIDA, permanently.
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;~:i' (Name) r q J~es Horre
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Swom to and wbsuibed before me this 7th day of (ktn~r , ~9~.Q.
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ROGER r0lTRAS
CLERK CIRCUIT COURT . Notary Public
By D.C. My Commiuion expires
(Te b~ ~x~cul~d in dupljcah and ori~insl filad wiTh Ci~elc Cirail Coue1, and dupticaN wilb Taoc At~ora
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