HomeMy WebLinkAbout0498 Declaratio~ ot Domicile and Citizenship .
TO THE STATE ANU COUNTY TAX ASSESSOR, `
Sl. LUCIE COUNTY, FIURIDA:
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(his is my declaration of Oom~ule and Citizenship in the State of Florida that i am filing this day in accordance and ~
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~n conformity with Chapter ~22, Section 222.17, Florida Statutes. i
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I was formerly a legal resident of ~ '
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and I resided at J~'~ L~~-`' 1`F However I have changed my domiu~e ~
(Street and Number) ~
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ro and am and have been a bona fide resident of the State of Florida since J~x /~~7 ~ _ day of
J~p`/ 4~C~' ~ ~ L
, 19_ , and I reside at -i~-- ~ ~
~ (Street and Number) . /
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FORT PIERCE, SAINT LUCIE COUNTY, fIORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removat of famiiy to new domicile, purchase of home, etc.)
~ FILEO AkU RECORDEO
ST. WC1E CJUNTr FLA.
ROCEi~ PJ~TRAS ~S i
CIERK CtRCUiT COURT '
RECORD VfRIFtEO~
FEe 11 i 49 PM't I
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~ I FURTHER CERTIFY that 1 will comply with airother requirements of a legai resident of this State.
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I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT _ ~
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ (Name) / ~
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, (Address)
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~ ~ Swoul.io-.and subxribed before me this day of -~~C~-~- - , 19~~
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~ i ~ ROGER -pORRAS - - -
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~ Ct~GRCUIT COURT Notary Public
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~ gy~~ • ~ _ D.C. My Commission expires
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~ (To be executed in duplicate and originsl filed with Cl~rlc Circuit Court, snd duplicate with Tsx Assessor.)
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