HomeMy WebLinkAbout0886 f~~0
- O~aluatio~ ot Oomiafl~ and Citl~~nshlp
TO THE STATE ANO COUNTY TI?X ASSESSOR,
Sl. U1CIE COUNTY. FIORIDA:
Thi: i: my declua~ion of ~omicil~ and Citii~nihip in th~ St~t~ of Horida that I~m fili~q this d~y in aooordano~ a~
~n co~formity with CMpt~r 222. S~ction 222.17, Florid~ Ststutts.
I was formerly a leqsl resid~nt of -Y~~ r~~~ - _~_Y~~ -
(City) (51ah)
and 1 rosidad et lll N~1't6 aih ~r„~~ 1 have charped my domicjle
(Sh~et •nd Number)
ro and am and have been a bona fids rosident of the Stah of Florida sinoe i day of
_ _ , 19 and 1 reside at ~Tm S~*~: al_._o_____H_Pi_..~T~Is•
(Sneet snd Number)
FORT MER~E, SAlNT IUCiE COUNTY. RORIDA
and this statement is to be taken as my dacla~ation of titizer?ship, attual fegal r~idenoe a~d domicile in fhs Staro of Florida.
(Insert he~e any peninent fads, such as sale of property or business, or ~elinquishment of employme~t
at former domicile, removal of family to new domicile, purchase of home, etc.)
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~ I RIRTHER CERTIFY that I will aomply with all other rsqui~ements of a lepal renident of this State. _
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~ 1 FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and 1 intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ (Name) IN~~t¦e't•
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,~~,U~ ~~i~o and wbxribsd before me this day of , 19
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..y ~ C't~K.lb~~~ Notary Public
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B~ ~ D.C. My Gommission expir~s
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R~ b~ r,c~aM~ iu d~kSN and ~iMl fi~i wNl~ q«~C praiil Cwtr~, ~nd duppsat~ wilb Tax 11~e~.)
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, 3 e~K 1~9 ~ 883
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