HomeMy WebLinkAbout2712 Declaration ot Domicile a~d Cittzenship s
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIC~RIDA:
This is my declarotion of Domicile and Citizenship in the State of Flo~ida that I am filing this day i~ accordance a~d
in rnnformiy with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of Atlanta _ Georaia _
~ (~;y) (State)
and 1 resided at C@IItT81 AV~. _ . However 1 have changad my domitile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ~ 1 day of ~
_ ___QCt~ber , 19~'~, and I~eside at 25th 3trest a~1d Ave. E~ Ft. P1e~'Ce
(Street a~ Number) ~'lorida
PORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration o.f citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent 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.)
FI~EO AND RECORDED
residence ~~„CIE COUNTY. FLA.
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Si~ FFg I3 aM IL~:IS
, ~~~RF: C;n~~IT COURT
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~ I FURTHER CERTIFY that I will comply with all other requiremenfs of a(eyal resident of this State. (
~ I FURTHER CERTtFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ CORDIEZIIIS LASTER Jr.
~ (Name)
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~ Corner 25th. Ave. E
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1 , (Address)
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~uburibed before me this 13 day of Pebrvary ~ ~q ~Q :
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~ Notary Public
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~ 8 - . D.C. My Gommission expires
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~ (i~;~~C ,x_ ~id duplieah snd ori~inal fil~d wkh CIKk Cireuit Cou~l, and duplioat~ whh Tax Ass~ssor.)
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