HomeMy WebLinkAbout0869 Declaration ot Don~icile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FLORIDA:
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This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day i~ atcordante and ~
~n conformity with Chapter 222, Seclion 222.17, Florida Statutes.
1 w f rmerl a I al resident of - - - - " -
as o y eg
~City~ (State)
and 1 resided at 1_ Cf C~. . Howeve~ I have changed my domiCjle
(Street and Number)
to and am and have been a bona fide resident ot the State oF Florida since ~_~._~~day of ~
. _ _ _ 19
7~ and I reside at _s2~ - ~ p--~~_ o~' g /.1-~ - - - -
(Street and Numbe~) i
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my dectaration 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, removal of family to new domicile, purchase of home, etc.)
Applying for h ~estead
4tEC0R~
2U4S3
i i~`aoG~fapON~AS~~
CLEO
~Eaif~E1~ COU~-
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I FURTHER CERTIFY that I wifl comply with al) other requirements of a legal resident of this State.
~ FURTHER CERTIFY that I have no intention to return to my former domiu~e, and I intend to remain i~ FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently.
~ . . • = ~ -
~ • ~ Albert C ~~u~~ras
~ • . _ - , _ `~G';'''-
_ : : ~ ~/L ~Ad~kess) • ~
~ ,<`r,: ~ ~ ~
~ :
~ , Sworir'1'o ~and subsc~ibed before me this day of - , 19~. ~
~ -
~
~ ROGER POITRAS -
~ CIERK CIRCUIT COURT Notary Public '
4
~ S - D.C. My Commission expires
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(To b~ ~x~cv»d in duplicaN and orip+nal ~iled with Cltric Grcuit Cour1, snd dupliut~ with Tax Ass~sfor.) ;
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