HomeMy WebLinkAbout1436 D~la~ation ot DomlRil• and C1tis~nship
TO THE STATE AND COUNTY TAX ASSESSOR.
51, lUC1E ~OUNTY, FLORIOA:
This is my decleration of Oomicile and Citis~nship i~ the Stete of Florida thst 1 em fili~q this dey in aooo~d~no~ a~d
~n tor~formity with Chapter 4??, Ssttio~ 222.17, Floride Stetutes.
I was formerly ~ legal ~esident of ~th ~batar
(Cty) (Staro)
and I ~esided at South ~bb~ter, Bont• 8 . However 1 have chanyed my domidle
~ (Stroet and Number) -
to and am and have been a bona fide resident of the State of Florids sinoe ~s day of
, 19~ , and I roside at g6~ Jahns~ j~. p~~so•
l~la. - (Stroet and Number) _
FORT ~IERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my detlarotion of citizenship, actual legal residence a~d domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of properry or business, or relinquishment of employme~t
at former domicile, removal of fsmily to r?ew domicile, purchase of home, etc.) •
Plaoiag ahild ia pt~lio acbool - D~bereh Hilt~rbr~nd
- ~ FIL'ED AND~RECORO~E~,
~ ST. LUCIE .COUNTY: FE.A+=
RECORD V~R~IF,~1~0~
~3
'10 lu16 19 PM 12: 46
ROGER POITRAS
CLERK CtRCU1T COURT,~
i
f
~
~
I FURTHER G'HtTIFY that 1 will aomply with all othx requirements of a Is~al ~esident of this Stete.
1 FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
- ' ~
(Name) Laur~ Hilt~rbran d
~ ? -
~ (Addres:)
~ _ , . 1 ~
.~'~;~wofh to and sub;uibed before me this day of ~~~t , 19 ~
_ : ~
ROGER ~OITRA~; ~
~ . CL~K CIR~YIX Notary Publk
- -
gY " •C. My Gommi~slon ~xpins
_ / , V . .
R. b..x.c~.d in d~pWcN..e~d o.rotnal tii~d whM u«~C ci~wrM c.w+, aad d~puW. wi11~ tax A...«..a
_ e~~~~ ~i434