HomeMy WebLinkAbout2109 Declaratian ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~ 19i~;~~
Sl. IUCIE COUNTY, FL~RIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in acco~dance and ~
in conformity with Chapter 222, Section 222.17, Florida Statut~s. `
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1 was formerly a legal ~esident of ~~.11T1 I11 _ f
:
(City! (State)
and 1 resided at Rt _#1 , BX 136 ~We~e~ 1 have changed my domiCi~e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ~ day of
_MeTah_ , ~9 70 , and 1 reside at 2406 A. 43Td St.
(Street and Number)
FORT PIERCE, SAIPiT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domitile in ihe State of Florida.
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(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
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at former domicile, removal of family to new domicile, purchase of home, etc.) ~
child in sehool ~
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Todd Eric Thomas 6 years of age ~
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' FiLED AND RECORQ
ST. ~V~~E COUNTY ~ '
p~COR~yERIF1Ep A'~ '
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i ~ 91496 ~
TO ~
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{ RUGc r FOrTRqg
~ ~LERK CIRCUIT ~OUR~
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~ 1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. ~
a ~
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1 FURTHER CERTIFY that 1 have no intention to return to my former domiCile, and 1 intend to remain in FORT ~
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
~ - ~J
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_ (Name)
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y E
~ ~ 244b No. 43rd. St. ~
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~ . . ~..::.:~tt~~ ` : - (Address) i
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f~woni~o ahtf'~~~It~ed before me this 25th day of hSaTCh ~ ~q 70 {
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~CI~~ ~~ikT ~ ~ Notary Public ~
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By D.C. My Commission expires
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~ (To be executed in duplicaM and ori~inal filed with Cle~fc CircuH Court, snd dupliut~ with Tax Asssssor.) ,
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~ BOOK ~O~ PACt ~G,~O~
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