HomeMy WebLinkAbout0624 D~cla~ation ot Dorr~icil• and Citi:enship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE COUNTY, flOR10A: 20 ~y.y~ ,
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This is my dccla~ation ot ~omicile and Citizenship in the State of Florida that I am filin~ this day i~ aaordanoe snd
~n conformit~; with Chapter 22Z, Section ?22.17, Florida Statutes.
1 was formerly a legat resident of ~4 ~ _
(~iry) (Stats)
~
end 1 resided at _ . However I have chanqed my domidle
- (Stroet and Number)
!o and am and have bcen a bona fide resident of the State of flotida since ~ f~ day of
. 19...zQ, and I roside at~~~ f~ D ~r p~ p~~.ti Q
~ (St~eet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIOA
and this statement is to be takan as my declaration of citizenship, actval legal residanoe and domicile in ths State of Horida.
(Insert here any perti~ent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purthase of home, etc.)
!X ~-~-~'l fil¢iy._ ~Gs.... ~ ~~o
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I FURTHER ~ERTIFY that I will canply with all other rsquirements of a(eyal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to retum to my former domic,ile, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA; permanently.
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~ Swoi4i_t0'~rid;~,l~cribed befo~e me this ~ day of - - ~q
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~ . '.;"_s!1~d~~'•~ 1,
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~ _ CIRCU~~URT
~ Notary Public
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~ BY ' ~ •C. My Commission expires
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~ 't., ~ ~ • '~~y,~.,~i-`
~ Ro b~ ~x~evl~d in du iuN and
~ pl ori~inal Al~d wilb C{Nlc GrcuN Court, and dupliut~ wilh Tax A~or.)
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No. 13
~ a~189 ~ 6~~3
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