HomeMy WebLinkAbout2650 Declaration ot Domicile and Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Flor~da that I am filing this day in accordance and
~n conforrnity with Chapter ?22, Section 222.17, Florida Statutes.
I was formerly a legal res~denr of Greenville Soutt;_~arolina
(City) (State)
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and I resided at 2~9 ~~~~f~$X~$. AU~118t8 DY'. However I have changed my domic,ile i
(Street and Number;
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to and am and have been a bona fide resident of the State of Florida since 2nd day of ~
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C~ctober , 19_ .7~, and I reside at _ 1113 iieaCh Ct. _
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this staternent is to be taken as my declaration of citizenship, actual legal residence and damicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or telinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
(i~omestead ~xemption) ~
Fi~Ea Ako sE
tt• ~uc~~ cour~r~;(
AOCER POITRA~
RECORO vERRFiEOT~-~D~
~t 1S II 14 AN'l~ ~
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~ I FURTHER CERTIFY that I will comply with all othEr requirements of a I~egal resident of this State.
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~ 1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
~ PiFRCE, SAINT LUCIE COUNTY, FLORIDA, permanently. b;SY'g3Tet L. C1arK (i~Cr3. Harold C. )
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= Sworn to and subscribed before me this .___26th day of CtOb~T ~q 7U j
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gy D.C. My Commission expires _ ~
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~ (~~~F. •~~pliut~ and ori~inal ~il~d with Cl~rlc Cjrcuit Court, s~d dupliut~ with Tax Ass~s~or.I
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~ s~~~;:~~~~'~ ~ R 1.87 2649
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