HomeMy WebLinkAbout1221 O~la~ation ot Domicil• a~d Citi:~nship
TO THE STATE AND COUNTY TAX ASSESSOR,
2U31~~~ `
Sl. LUCIE ~OUNTY, FIORi~A:
This is my declaration of Oomicile and Citize~ship in the State of Flo~ida that 1 am filin~ this day in acoordencs and
~n confor~nity with Chapte~ 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of p ,,~C~~ 9~~
(City) (State)
and 1 resided at /`t~.Po~t/k%do~ T~P /y~'~' ~iP~ ~~~1 However 1 have chan9ed my domitile
(Straat and Numbe~)
to and am and have been a bo~a fide resident of the Stste of Florida since /Z -L - ZD day of
- . 19 and I reside at ~.vT~PAdN i4v~
(Street and Number)
PORT PIERCE, SAINT LUCIE COUNTY, RORI~A
and this statement is to be taken ~as my declaration of citize~ship, actual legal residence and domicile in the State of Horida.
(Insert he~e any pertinent fads, such as sale of property or business, or ralinquishment of employment
at former domicile, removal of family to new cbmicile, purchau of home, etc.)
~.o ~\e~Y. MARY ~aN~s
A~~'. ?o y c~RS ~
Rt~. d r~~"e 3_ b~ .
~I• ~NCf
E COUMTr
~L[RR C RCIlIT
AECORO YERIi1r0~C
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I RJRTHER CERTIFY that 1 wil) comply with all othe~ requiremants of a le~al resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicGie, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ i,iJiT.;~.~,
~ - ~ : • ....t.....,~ ~ . (Name)
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~ " •n ~ ;~~`,.:~,,~~''1-:~;•.~~ . (Address)
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~ ~+(yp:~jt?~scribed before me this day of , 19 7~.
'~~,~.,ottti~~~
~
~ ROGER rO1TRAS
~ CIRCUIT COURT Notary Public
~ 6y S-'~ ~ h~-- D.C. My ~ommission expires
~
~ lTe b~ ~x~euhd in duplieah and ori~inal Rf~d with ClKk Ciraih Coue~, and duplieab with Tax A~or.)
~ ~ , 3 ~~K 1E9 F~~?1~~.~
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