HomeMy WebLinkAbout2287 2C18~:'~
Decla~ation ot Oomicil~ and Citis~nshi~
~ TO THE STATE AND COUNTY TAX ASSESSOR, . ' '
Sl. lUC1E GOUNTY, FlOR1~A: ~ . "
Thi: is my decluatial of Oomicils and Citiuhship in tM St~t~ of Piorida th~t 1 am filinq this day i~ aooordat~o~ and
in conformity with ChaptK 222. S~ttion 42~.17, Fbtida Statut~t.
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I was formerly a Ipal rosid~r?t of ,
` (City) ISf~M)
end I tesided at 2..y~ ~e~ - How~vK 1 haw thu~q~d my dorr~ic3li
(Stnit and Number) .
ro~nd am and hsve been a bona f'~ rosid~nt of the Stats of Florida sina ~ -~Y ~
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19~, and 1 t~ide at
(Stnes and Numbe~)
FORT PIERCE, SAINT LUt1E COUNTY, lLORIDA ~
and this statemsnt is b be taken as my declaratio~ of citize~ship, actual leqal residenos and domicil~ in th~ St~ro of Horid~.
(In~~t here a~y pertinent fact:. :uch as sale of propsrry or bu:i~sss, or rolinquishm~nt of ~rnployment -
at formsr domicile, romoval of family to n~w domicil~, purcha~ of hon~, Nca
. ' 2,(,1.8'7 J .
Fafo ~wo aECOapEo
iT. ~.UCIE COIINTV fLA..
ROCEa POITIlAS
CLERK CIRCUIT L .
RECORD VERIFIEO
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I FURTHER CERTIFlf that 1 will aomply with ~II othK nquin~r~snts of • Ipal ~ident of this Stat~.
I FURTHER CERTIFY that 1 have no intention to retum to my former domi4le, ~nd 1 intend to r~main in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, perman~ntly.
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