HomeMy WebLinkAbout0823 Oecla~atio~ ot Donsicil• and Citis~~ship
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. WCIE COUNTY, FIORI~A:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance e~d
~n confo~mity with Chapter 222, Section 222.17, Fiorida Statutes.
1 was formerly a legal resident of __~a11~bLiZ'~ Idilli _ New York _
(Ciy) (State)
and 1 resided at ---_G• D• _ However 1 have chanyed my domiCile
(Street and Number)
to and am and have been a bona fide resident of /he State of Florida sinte lst day of
------s1L~~--_--____ , 19?~ , a~d I reside at 9~3 S. 27tl1 St.
. (Street a~d Number)
FORT ~IERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the Stete of Horida.
(Inse~t here any pertinent facts, such as sale of property or busineu, or ~elinquishment of employment
at forme~ domicile, removal of family to new domicile, purchase of home, etc.)
(Homestead ~gemption)
202865
f11E0 AMfl REC~QIt~~
aT.110CER POITRA=
C~EItK CIRCUIT CQURT ~~'t
RECORO YERIf1E0
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~ 1 FURTHER ~HtTIFY that 1 will comply with all other rsquirements of a leyal resident of this State.
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~ . I FURTHER CERTIFY that I have ~o intention to retum to my former domicjle, and I intend to remain in FORT
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~ PIERCE, SAINT IUCIE COUNTY, FIORIDA, permanently. C8es8T Berra
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# Sworn to and subscribed before me this 4th daY of d8AU8Ty 19 71 ;
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~ Notary Public
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~ BY ~ Y D.C. My Commission expires
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