HomeMy WebLinkAbout1743 D~cla~ation of Domlall~ and Citlsfnship
2~~~y~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE GOUNTY. FLORIDA:
This i: my declaration of Domicilt and Citiz~nihip in th~ St~t~ of Florid~ that 1 am filinq thls day in acaordano~ and
in conformity with Chapter 22~, Section 222.17, Florids Statuh:.
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I was formerly a legal ~esident of -
(City) (Sta») -
and 1 ~esided at ~L1 y~~~~L~~-/~-- _ However 1 have tharped my domitile
(Strest and Number)
to and am and have baen a bona fide resident of the State of Florida since da of
- f~ Bo1C y~ P~ - c
_ , 191L_, and I roside at •
(Street ~nd Number)
~RT MERGE, SI?INT LUCIE ~OUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual Isgal residenoe and domicile in the State of Florida.
(Insert here any pe~tinent facts, such as sale of property or business, or ~elinquishment of employmsnt
at former domicile, removal of family to new domicile, purchase of home, etc.)
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FILED AMO RECORQEp
ST.LUCIE COUMTY FIA.
ROCER POITIUS
~ CLERK CIRCUlT COi!
RECORO VERIFIED
Ju~ 19 i2 32 PN'T I
2U349;
f .
~ . _
I FURTHER CERTIFY that I will comply with all cthsr requiremenfs of a leqal resident of thls State.
I FURTHER CERTIFY that I have no intention to retum to my former domicjle, a~d 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ ~_$~worn to a.r~ ~~SUibed before me this __LL- day of t , 19.~~
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C~lIT Notary Public
~ 8y D.C. My .:ommisiwn expires
~
Ro b~ ~x~cvhd in duplicat~ aed ori~nal fil~d wiMi Cl~lc qrarit Co~r~, aed dupliah wi~h Tax A~er.)
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