HomeMy WebLinkAbout2414 O~ala~atio~ ot Domlail• and Cltis~nship
TO tHE STATE ANO COUNTY TI?X ASSESSOR,
51. IUCIE COUNTY, FIORIDA:
This is my declaratio~ of Domicile snd Citizenship in the State of Florid~ that 1 am filinq this dsy in sooordenu and
~n conformity with Chapte~ 222, Section 222.17, Flo~ida Statutes.
I was forme~ly a legal resident of ~"f T~ f L /A~ /~f. _ p,Ej~/~ ,
(City) (Stah)
and I ~esided at `~~3 ~'6'¢'~'~y ~~D However I have chanyed my domic3le
(Stteet and Number)
to and am and have been a bona fide reside~t of the State of Florida since 3I ~i~~RTy F~'. day of
~~G~t~f/~,~ , _ , 19~a , and 1 reside at wK ~.Anr,~ ~i/fR PR~
(Street and Number) (
FORT MER SAINT LUClE COUNTY, RORtDA
and this statement is to be taken as my declaration of citizenship, act~al legal residence and domicile i~ the Stata of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment ~
at former domicile, removal of family to new domicile, purchase of home, etc.) 20~ai?y
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1 FURTHER CERTIFY that I wilf aomply with all other requirsments of a le~al resident of this State.
~ I FURTHER CERTIFY that I have no intention to return to my former domicjle, and f intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORlDA, permanently. • ~
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~ M~lper'iuburibed before me this day , 19 .
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ROGER ~ll1'TRAS
~ CIRCUiT URT Notary Public
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By O.C. My Commis:ion expires
~ ITe b~ ~x~whd ie duplicata and ori~inal Al~d wilb C{~eic Cira~il Co~et, and duplleal~ whh Tax At~er.)
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