HomeMy WebLinkAbout1502 Y
D~laration o1 ~ Do~niail~ a~d Citis~nship
TO THE STATE AND COUNTY TAX ASSESSOtt. .
s~. wciE couNT,r. F~oaioA: _l~~`74~2
This is my declaretion of Domicile and Citis~nihip in th~ Stat~ of Florida that I am filin9 thit d~y in aooo~dana and
i~ conformity with Chapfer 22Z. Section 2Z2.17, Florida St~tutes. ~
I was forme~ly a legal ~eiide~t of S!° a-h r'~~ _ 11 ~~_Y` S E. v _
(City) (St~h)
and 1 residad at ~~1171 ~~~Y' However I have charped my domic~le
(St~set and Number) ,
ro and am and have been a bona fide ~esident of d~e State of Florids since ~ day of
_ ~s~.~ , 19~, and I reside at Rt 3~ 5 4 1 Ca.. rn p b ~ I I 1^o a~,~
(Sheet and Number)
FORT ~tERCE, SAINT LUt1E COUNTY, fIORIDA
and this statement is to be taken as my declaratio~ of citiZenship, actual legal res+denos and domicile in the State of Florida.
(Insert here any pertinent fads, suth as sale of property or business, or ~elinquishment of employment
at fo~mer domicile, removal of family to new domicile, purchase of home, ett.)
~e. r r ~c~. n S~ n c~ er I~~ n
~
~ I-~ recj ~c~warr~l S~ n~erl? n SY.
:
~~I~p~ANO RECQRDL~ -
ST, (,(JC~E COUNTY; F~~
RECORO VERIFlEp .
~ - - 'TO ~ 20 pp~j ~
2.~
~ ROGER ~ ~ '2
~ CLERK ~as -
~
Rcv~T couRT~
~ .
f .
i FURTHER CERTIFY that I will oomply with all other requirsment: of a legsl residsnt of thi: Stsb.
I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to ~emain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
- ' . ~ ~ ~ . M A L' /
~ ~T
(Name) .
~T 3'~ S hl 1~~ m_ ,c~
b~~ . -
_ ~ (P?ddress)
.i~~ii:~ll~jl;~•' ' '
~t', : ; - ~ -
> ~
y.'~`~i;.~,~~+d wbsaibed before me this ~ d day of 19 .
t-':,~,:~' ; ,
ir"• ,4
= j T~' : ' . r, ~l .
'~.~i~??.. f `j~..~,:_ `
~
~ , r
~ T~ ' -~,E~K: Notary Publk ~
' , ' • . ~
; ~ r: :
8y c - D.C. My Commitiwn ~xpir~
. , `r~ J^
~ ; ,
C1~ t
~
~ s; ;;t~'~
R~ b~ aaarl~i M dvplical~ and ~eioinal fiMd wilb CIMIc Gew~N CwN, ani ~pNsa/~ wilb Tax Aw~~,l ~
~s - SDtnc i~ f~E i~ 1
_ : vr~ : _ _ _ . . _
- ~Q ~ ~ -
~ :,~ti -