HomeMy WebLinkAbout1512 Decla~ation ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX A~SESSOR,
Sl. LUCIE COUNTY, FIORIDA: ~
Th~s ~s my declar~tion of Dom~ule and Citizensh:p in the State of Florida that 1 am filing this day in accordance and i
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;n conform~~y with Chapter 2?2, Section 222.17, Florida Statutes.
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Bloomfield i~ew Jersey
I was formerly a legal resident of -
(City) (State)
an~ 1 resided at 85 Floyd AV2. _ _ _ However 1 have changed my domiCile '
(Street and Number)
~o and am and have been a bona fide resident of the State of Florida since lst day of
Rt. ~2, Box 3645
October , 19_ and I reside at _ Saltlt .I~u~1.~_~~.t_-_~---
(Street and Number)
fORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual {egal residence an~ ~~micile in the State of Florida_
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employme~t
at farmeo domicile, removal of family to rtew domicile, purchase of home, etc.)
(Homestead ~:xemption)
~ FILEp ~ `
. ST, LV~ANO-RECOR~Ep~
RECORp QUR ~yfb~,~
~l~ OCT 6 Aly 10~~~3:
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` ROGER ~-r`P '
` CLERK ~~TR,qg ;
~ CIRCV~T CO~TJ ~
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I FURTHER CERTIFY that I will comply with all other requirements of a legal rosident of this State. j
I FURTHER CERTIFY that I have no intention to reiurn to my former domiGie, and 1 intend to remain in FORT
PIERCE, SAINT IUCIE COUNTY, FIORIDA, permanently. JOyCe A. Dove
. , .
(Name)
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~ ;
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_ -
(Address)
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~ Gctober 7U_
6 th _ day of - - , 19-__
Sworn to and subscribed before me this
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f.: _ ,
~ ROG~` ti: •H, '
~~i
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, _
` ,b % Notary Public
Y ~ a ~
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G
~y ' D.C. My Commission expires
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(To ' and aKigin~l fil~d wifh Cl~trlc Grcuit Courf, and dupliut~ with Tax Ass~ssor.)
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.,,;~,l~.S~;~.~~ B~R~ 187 YA~~ 1512
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