HomeMy WebLinkAbout2509 D~aluatio~n of Oo~nlall• a~d Citis~nshfp
TO THE STATE AND COUNTY TAX ASSESSOR.
Sl. IUCtE COUNTY. K~~o~?: 2c~i~fi~)
This is my decla~ation of Oomicil• and Citi:inship in tM St~te of Fto?id~ that 1 am filin~ this d~y in ~ooord~no~ ~nd
~n conformity with Chapter 2Z2. S~ctio~ 2~2.17, florida Statut*s.
1 was forme~ly a IeQal resident of _~~R~~~ c~1.u/~ _ dl~~c.J
~(Ciy) a»)
and 1 ~esided at ~j.~~ L~~'~, ~wever I have changed my domic3le
(Sirest and Number)
ro and am and have been a bons fide ~esident of the State of Florida sinoe day of
- t ~a- . 19.Z~=. and I roside at ' ~ {
(Street Number)
~ORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this stateme~t is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertine~t facts, such aa sale of properry or busineu, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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ST.IUCiE COUM~Y Fl~•
110CER P01TpAS
11EC0lt0 VEIUFIED CO~~T
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2038E~:"i
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~ 1 RJRTHER CERTIFY that I will comply with al) other requiramenri of a leya) residen? of this• State.
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1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ _ (Name)
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~ ~~n,:tqrand subsuibed before me this ~ 7 day of ~uict 19~
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~ ' CL~K CI CUR COURT Notary Public
~ BY , O.C. My ~ommiuion expires
(To b~ ~x~aM~d in du~icah and ori~inal Rl~d whh Cl~ek qnarif Cowf, a~ duplieMa wNh Tax A~o~.~
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