HomeMy WebLinkAbout2772 D~ala~'atioA Of OOmlall~ aM! Citls~nshlp `
TO THE STATE AN~ COUNTY TAX I~SSESSOR,
y~
Sl. ltJC1E COUNTY. FlOR10A:
Thi: is my declustlon of Oomicil~ and CiH~it?ip in th~ St~t~ of Horid~ that 1 am filinq this d~y in aaoordano~ and _
in aonformity with Chapttr ~22. S~ctior? ~22.1~, Florida Statutt~.
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1 ws: formerly a leyal rosid~nt of
~ ~ (Cth?)
and I resided a't Howwer 1 hsve chanq~! my domitile
(Street and Numbsr) _ . , Q
rT
ro and sm and hsve been a bona fide ros'wtent of the Sts» of florida iinoe ~Y ~
.
, 19~, and 1 reside at ~ -
. (Street Number) ,
l~ORT N~, SAIi~lT LUCiE COUNTY, RORiDA
and this atatemenf i: to be taken as my declaration of dtizenship, actual le~al ~es'~denoe and domidle in the State of Florida.
(Insect here any pe~tinent fads, such as sale of property or busir~ess, or relinquishment of empioyment
at former domidle, removal~of family to new domicile. purchase of Fwme, Mc.)
FiLED AND RE~qRDEO'
- ~ ST, IUCfE COUNTY; F~A:.
. i3EC~RD.~~ERIFtEO
'l0 ~~~2
- ~ : JUL 20 Pp 3:59
~ c~ ~oc~~ ~o~'~
ERK
CIRCUIT COURT:
~ .
~
! FURTHER ~HtTIFY fhst 1 wili compiy with all othsr requinrnenb of a leysl residant of this Stat~.
1 FIJRTHER CERTIFY that i have no intention to retum to my former domicils, and 1~ Intend to remain in FORT
PtERCE, SAItVT LUCIE COUNTY, FLORIDA, permanently. ,
iNa
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~o and wbauibed before me this day of ~ 19~~
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~ . Not~ry Publk -
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~ ~ ~j . O.C. My Commissbn ~xpins
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