HomeMy WebLinkAbout1720 Declaratio~ ot Oorr~lcile and Cittze~ship 1s~022 ~
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Sl. LUCIE COUNTY, FLORI~A: ~
This is my declaratio~ of Uomicite and Citizenship in the State of Florida that I am filing this day in acoordance and
in confo~mity with Chapter 222, Section 222.17, Florida Statutes.
I ~
I was formerly a legal resident of Centereach, T,OYIg 818IId ~@W York ~
(City) (Stab)
and 1 resided at 133 TLidOZ' R08d ~?owever I have changed my domic,ile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 218t day of
~~e , 19
6~, and I reside at 192 Liberty Way, ;
(Street and Number)
~
~
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA - ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Norida. '
(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.) ~
eetabliah reeidence
FtLEO AND RECORDED~ ~
ST, I.UCIE COUNTY. FLA. ~ !
k~.COKr V~'RirIEL~ ~
~ ~ - 1890~2 ~
t
'ZO JA~ 30 AM 11:39 ~
,
.:e~~~ ; o;-RM
CLERK C1RCllIT COURT_ ~
i
~ ~
~ ~
I FURTHER CERTIFY that I will comply with all other requiremenis of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my fo~mer domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. •
6~C~
JOA~T C IACC I
(Name)
192 Liberty Way, Ft. Pierce, Fla.
_ ~ _ (Address)
.,:..1.- . ,
;~.,_.-,..J':..
, ~ . _
-~Y $wo~tr~~tbfail4!'S~tibsccribed before me this 3~th day of January 19 'j~
_y _ - r::,~z'• :i~ r ~
' ~i ~ - .
~ ~ +1~;~~ ~ .
• ~ ~ ~ :-'~lERK- .CQt :COURT Notary Public
l~. • J,`i~ •
, f,, • ~ ~
~ I
By . ~-D.C. My ~ommission expires
(To b~ ~xecuted in dupliwM snd ori~inal fila~ ~rit~ ~y~y~c Circyit•~, and duplicat~ with Tax Ass~or.)
600K 1 PAGE 1 / .10 ~
~ r~o. ~ s
~
~f - _ -
~ " - ~
~ ~ . ~
`.~`;~c~'`~ ~