HomeMy WebLinkAbout1459 aclaratlon ot Domicli• a~d Citls~nship
TO THE STATE ANO COUNTY TAX ASSESSOR,
51. IUCIE COUNTY, FLORIDA~
This is my decla~ation of Oomicile and Citizenihip in the Stats of Florid~ that 1 am filiny this day in acnord~nos and
~n co~formity with Chapte~ 222, Section 222.17, Floride Ststutei.
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I was forme?ly a leqal resident of _ - _ _
(Cify) ah) ~
and 1 resided at -------5!~~„L_ ~GQ~~s~C~+a~-(C~- Howevar 1 havechan~ed mydomitile
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to snd am and have been a bona fide ~esident of the State of florida since ~ day of
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- - i . 19 , and 1 reside et ~9B ~ S• 'r~ p°. 8^~ I~'yy
(Street snd Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my decla~ation of citizenship, actual legal reside~ce and domicile in the State of Florida.
(Insert here any pe~tinent facts, such as sale of propery or busineu, or relinquishment of employment
at former domicite, removal of family to new domicile, purthase of home, ett.)
2t~3319
fIlEO ANC RECOit 0
st. ~uc~f caw+t~r ~i~.
aacEa PaiT~u?s
ClE1tR CtRCUtT C81i~t
RECORD YERIFIEO~~~'
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f 1 FURTHER CfltTIFY that I will aomply with all other requiremenK of a lega) resldent of thit State.
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~ 1 FURTHER CERTIFY that I have no intention to return to my forme~ domiGle, and I intend to remain in FORT
~ FIERCE, SAINT LUCIE COUNTY, FLORtDA, permaneMly. Y~ ?/Q ~t So ~
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~ Sworn to and subscribed before me this l L~ day of - , 19~
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~ Notary Public
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~ 8y D.C. My Commission expires
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