HomeMy WebLinkAbout2724 D~la~atio~ of DomiQil• ~d Citis~nshlp 2U4~~'i
YO THE STATE ANO C'OUNTY TAX ASSESSOR.
Sl. WCIE COUNTY. FIORIDA:
This ia my d~cl~ration of ~omicit~ a~d Cltiztnihip i~ tM St~N of fbrida that 1 un filinp thi~ d~y in ~ooord~~a ~+d
in conformity with Ghapttr 422, S~ttion 2Z~.17. florida St~tutss.
1~w~s fo~mKlr • Ipd raid~nt of ~'~_L ~~A' ~
(Cih?) (St~h)
snd t rosidsd at ~a ~ D !~l ~i4 ~ O L!J ~ HovwvK 1 have ch~n~ed my domiti~e
(Stnet and Number)
ro and am end have been e bona fids resident of the Stab of Florida sinoe v.~N~ d+y ~
- - . 19 , snd 1 roside at L~ ~ l v~ .~~d ~ ~R ~
(Stnet ind Numbsr) '
FORT rIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement i: b be taken as my declantion of citizenship, actval legal residenoe and domicile in the State of Florida. -
(Insert here any pe~tinent fatts, such as sale of property or business. or relinquishment af employme~t
at formK domidl~, removal of family to new domicile, purchase of tarr~e, ~tc.) .
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fj ~+~D RECORpED
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~ 1 FURTHER CERTIFY that 1 wlll oomply with all other r~quitem~nts of ~ Ipal ruide~t of this State.
1 FURTHER CERTtFY that ! have no intention to retum to my former domic~le, snd 1 intend to remain in FORT
PIERCE, SAINT IUCIE COUNTY, FIORIDA, permanently. BERKI.EY J. DAVIS
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~ Sworn to and' wbsuibed befor~ me this day of 19-7~--.
ROGER P017RAS ~
~ CLERK CfRCUfT COURT Notary Public
~ B D.C. ~ M Commiuion ex ires
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~Te b~ ~x~arhd iw drplitab and ori~inal fil~d witb CINk Circvil Carrt, and dupliub with Ta~t Ass~ora
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