HomeMy WebLinkAbout1465 D~clarat~on ot ~omicil• and Citis~nshlp ~
TO THE STATE AN~ COUNTY TAX ASSESSOR,
51. IUCIE COUNTY, FIORIDA: ~
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This is my declaration of Oomicile a~d ~itise~ship in the State of Florida that 1 am filir~q thi: day in scoordanoe and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal reaident of~ ' A N L y~ ~S T/~'rL~'S ~ i' ~~I~ / G O _
tCiy) (Sta»)
and 1 resided at 3_8
a~ _ 3~/r~ C//~C L t However I have chan~ed my domiClle ~
' (Shest and Number)
to and am and have been a bona fide resident of the State of Florida since~Q-.~1~ day of ,
S~w~rivo.V ,U R~v~
~G_! Q ~ \ . 19~~ , and 1 reside at ~T
2~. X i~ ~ ~AA'~ ~~ir'
(Street and Number)
FORT ~IERCE, SAfNT LUCIE COUNTY, RORIDA
and this statement is to be take~ as my declaration of citize~ship, actusl legal residence and domicile in the Stab of Horida. ,
(Insert here any pehinent facts, such as ssle of p~operty or business, or relinquishment of employment ;
at former domicile, ~emoval of family to new domicile, purchase of home, etc.)
A O~1 /NG /rv~ ~D M ES 7L~A-1~ EXEMr~Ti o~?
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2U3322
i11E0 AlIO IIECQ~R~EO
iT. LUCIE C4UM11 FLA.
ItOCER POtTIIAS
CIEitK CIRCUI? COURT L~ f
IIECOAD VERIFIEO~
1~ 2 ~6 ~N •T 1 -
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> 1 RJRTHER CERTIFY that I will oomply with all other requirements of a leya) resident of thls State.
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~ I FURTHER CERTIFY that 1 have no intention to return to my fo~mer domiCile, snd { intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ;
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(Name) y
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~ ~ t~} ~r~d~scribed before me this day of , 19~.
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~ ~~~''R'OOEw'' ~I~ORRAS
~ Ct~K CtRiCtlR COURT Notary Public
~ 8y ~Q D.C. My Commiision expi~es
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~ Ro b~ ~x~c~d in dvplkah and ori~inal Al~d wilh C{Nlc G?a~it Couh, •nd duptiaal~ wilh T~x A~~x.) .
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