HomeMy WebLinkAbout0593 ,
DeClaration ot DomiCile a~d Citizenshi ~
P
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. WCIE COUNTY, flOR10A: .
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in acco~dance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of ----p~ -
~C~fy) (State)
and 1 resided at 1819 31r 22nd Street _ However I hsve changed my domiCile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since - day of
s
i
- , 1918~9 and I reside at T02 Howie Ave.
(Street and Number)
FORT PIERCE, SAINT WCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(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.)
Filing ior homest ad~e=e~ption ~
FILED A~~D RE~OR~F~O .
cT, LUC1~ CGU ~~4F~ i
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. 19~~~
'TO fEB Z~ P~ !2 ~ 06 _-,1
i - - - - OURT - -
, CL~fiK CtRC1. T
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~ I FURTHER CERTIFY that I wil) comply with all oiher requirements of a legal resident of this State. €
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~ I FURTHER CERTIFY that I have no intention to return to my former domiCile, and 1 intend to remain in FORT
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~ PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently. -
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(Address)
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------5vvom tv-and-svbscribed-before-me. this ---~7- . day ~ x'_~_
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- - . - I~OGER Pdt~ffAS
Y' R CdURT - Nota Public
- . ;ttFRK-.~. C~y,t rY
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gy D.C. My Commission expires
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t' in du Uute and ori ~nal filed with Clerk Grwit Couet and du Uut~ with Tax As~essor.)
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