HomeMy WebLinkAbout1483 O~claratio~ ot Oo~nictl~ a~d Cltis~nship
TO THE STATE ANO COUNTY TAX ASSESSOR, 2C~
Sl. ltK1E ~OUNTY. FIORIDA: ~~~'~7
This is my clatla~ation of Dornicile and Citiz~nship in th~ St~ro of Horida th~t I~m fili~q this d~y i~ aoootdano~ ~nd
in oonformity with Chapte? 222. S~ttion 222.17. Florida Sh1uMs.
1 was fotmerly a leqal reside~t of _
(Ci1y) (Sta»)
and I resided at ~ ~ Ct- How~v~r 1 have dom' '1~
charq~d mY ~
~ (Sh~et and Number)
ro and am and have bee~ a bona fide resident of the State of florida sinos ~ day oi
- , 19~~ , and 1 reside at 3 l _
- C~ cr "r~.and ~ 4-c.P
F~RT N~CE. SAINT LUCIE COUNTY, RORIDA ~
and this statement is to be taken as my decla~ation of citizenship, octual leyal residence and domiale in the Staro of Horida.
(Insert here a~y pertine~t facts, svch as sale of property or business, or ~elinqui~ment of employmant
at former domicile, removal of family to new domicile, purchase of home, etc.) .
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ROCER POITIl1?~
- CLEItK CIRWIT COt1RT ~
RECORO vERIf1E0.~~
,~~s a~~M~T~
i 2C, 3338
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~ 1 FURTHER CHtTIFY that 1~rill oomply with al) oth~r r~qteir~rn~nts of a(pal r~sid~nt of this Stat~.
1 FURTHER CERTIfY that 1 have no intention to ~etum to my former domidle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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