HomeMy WebLinkAbout2565 ~~i10 `
D~aluatio~ ol Don~lail~ and CitlsMahip
TO THE STATE AN~ COUNTY TAX ASSESSOR. •
Sl. IUCiE COUNTY. FIORIDA:
This i: my declaration of Oomicile snd Citizenihip in th~ Ste» of Florida that 1 am fllinq this d~y in aooord~no~ e~d
~n oonformity with Chapter 222, Section 222.17, Fiaids Statut~s. ~
.
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1 was formerly a leqal ~esident of
(~ty) (S~ )
end 1 ~esided at 3- /`f ~'y"~ ''T--"""' !/'3 SC. Howevsr I have chan~ed my domic3~e
(St t and Number)
b end am e~d have been a bona fide re:ident of the State of Florida since 7~ day of
_ , 19 , and 1 ~esids at s ~
. - (Street and Numbet)
FORT MERC~. SAINt LUCIE tOUNTY, fLOR10A
and this statement ia to be taken as my declarotion of citizenship, actual leyal reiidenos and domidle in ths State of Horida.
(Insert here any pertinent facts, such as ssle of property or busines:, or relinquithm~nt of employmsnt
at fwmer domicile, romoval of family b new domiale, purchase of home, etc.)
Homestead - " ,
fT.IUCiE CQUNT~F~A.~
~ - IIOCER POITIUIS ~
CIERK Ci~CU1T C01t
RECORG YERIfiEO
~ 18 o~ ~M ~7~
2Q3910
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I RJRTHER ~ERTIFY that I wiil comp~y with ali other requirom~nb of • Ipal rasident of thb St~tt.
I FURTHER CERTIFY that i have no intention to return to my formar domitjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. g~y~j~ ~j .~pSTERSO~T
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~~I~ioi~i~~. ~d before ms thi: ~ day of 19~.
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CL~K ClRCUR COURT Notary Publk
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By ~ D.C. My Commiubn expins
R~ b~ ~x~arlyd iw drpNca/~ and ~inai AMd whb ClKk Cira~M Cw~1, a~i drplteaN witb Tax A~~J
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