HomeMy WebLinkAbout0339 Declaration ot Domicile and Citlsenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Ftorida that 1 am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
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I was fo~merly a legal resident of GeOr$~tOW~ K
~c'~, - (State)
414 $tOQQ AvEIIV@ . However I have chan ed m domicjle
and 1 resided at - - - 9 Y
(Street and Number)
to and am and have been a bona fide resident of the State of Florida s~nce ..1anuary 5___ day of
1970-, and I reside at ---3510 SO. V. S. 1
Street and Number)
FORT PIERGE, SAINT LUCIE COUNTY, FLORIDA
and ii~is statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida. 5
(Insert here any periinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bntering Tammy Lee Kelly in public school
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I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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( ame) Bett ~lly
~ (Address)
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~ ~ ?th Januarv ?0
~ . Sworn to and• subscribsd before me this day of . 19 •
~ {
ROGER PO{TRAS ~
~ CIERK CIRCUIT COURT Notary Public '
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~ g~ D.C. My Commission expires
3
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(To be executed in duplicate snd originsl ~iled with Clerk Circuit Cour~, and duplicate with Tax Assessor.)
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