HomeMy WebLinkAbout1401 2(~32`7~7
Otclaratlo~ ot Oornlall• ar~d Cltis~nahip
TO THE STATE AND COUNTY tAX ASSESSOR, .
Sl. lUC1E COUNTY. FIORIDA:
This is my declaratio~ of Oomicil• •nd Citis~n:hip in th~ StN~ of Horida that 1 am filin~ this day in ~oco~dano~ and
~m m~formity with Cfiapter Z22, Sectior? ~22.17, ids StatutK.
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1 wss formerly a leqal resident of
(City) at~)
and 1 resided at ~ ~ However 1 hav~ chan~sd my domic3le
. (Str~t and Number)
ro and am s~d have been a bona fide ~esident of the State of Florida ainoe .~eC`~~ day of
. 19.~, and I reside at ya ~ ~/~~.t, v„~
" (Stroet and Number)
FORT M~CE, S~iNT LUCIE COUNTY, RORIDA
and this stateme~t is to be taken _as my declaration of citizenship, attual leqal residenoe and domitile in the State of Horida.
i
(Insert here any peninent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domidle, purchase of home, etc.)
~'~d ~ S T6~4 1, .
2G32'7'7
st
~uciE cou~Y ~i~.
ROCER POITRA= ~
CIEtiK CIRCUIT COI11tT
RECORD YEtiIFtEO
,1~~ f 3 2 0~ PM'? I
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~ I FURTHER CEftTIFY that I will oomply with el) other rsquiromenri of a lepal resident of thi: State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend fo remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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~ L'~S~~r ind subs~cibed before me this I~~' day of , 19~.
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~ CL~K C~t!!R
COIlRT Notary Publk
~ Sy - D.C. My Commisiion expir~s
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~ R~ b~ ~ac~N~d ln dvplicNa and e~inal Ahd w~ CIMk Gra~if Carrt, and dvplieal~ wilh T~x A~~a
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