HomeMy WebLinkAbout2199 ~ l
. D~alaraUon of Domiail~ ahd CItls~nshlp
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TO THE STATE ANO COUNTY TAX ASSESSOR,
Sl. UJCIE COUNTY, RORIDA:
Thi: i: my declantion of Domicii~ and Gitizs~tF~ip in th~ Sta» of Horida that 1 am filirq fhit day in aooordana and
in oonformity with Chapter 2Z2, Sectio~ 2?Z.17, Floti~a StatuMs.
1 was formsrly a lege! rosid~nt of ~~M~U/~~ ~ 1
~ (Ci~y) tStaro)
and 1 rosidsd at O~ G~ ~ V~ . However 1 have tharpsd my domkile
(Stnef snd Number) - ~
ro and am and h+~ve been a bona fid~ res'ident of the State of Florida sinoe U~~ ~ day of
19~, and 1- roside at ~~~V ~~/~'SV Ip~ -/•s~~'I{!~ %FJ1_
(Street and Numbe~)
FORT N~CE. SAlNT LUCIE COUNTY, RO-RIDA - ~ - !
and this atatement is to be tak~n as my dedarstion of citizenship, actual legal rsaidenoe and domicile in the StaM of Horids.
qnsen hers any pertinent #acts, such as sa~e of propesty or bu:iness, or ~elinquishment of employmem
at former domidle, ~emoval of family to new domicile, purchase of home, etc.)
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-F1lED ANO _ RECOliG~
_ Sr. LUCIE COUN"~, .i,A;~_
, RECORD VERIFIE~
- ~95853
. 'TO JUL 10 PN 2:31 ~
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ROGER FOITRAS
CLERK CIRCUIT CO~1RT~
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i RIRTHER CERTIFY tfiat 1 will comply with all other requimments_of a Ispal resident of thl: State.
1 RIRTHER CERTIFY that I have no intention to retum to my former domi~jle, and I.intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~`~wp!1'~ ~fQ~end subscribed before me this . ~ day of ,~19_{
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'I~ CI~ ~1R COURT Notary Public
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By~~ D.C. My Commistion expires
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(r: i» .~o.~w.d fw duplica~. .nd e.i~inal~ fil~d wbl~ a.rk ck~it cew.+, .nd dvptiul. wMb Tas As~...o.a
: „ - a~K 185 ?A~ 2~'01
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