HomeMy WebLinkAbout1658 Declaratio~ ot Oomicile and Citisenshlp
TO THE STATE AND COUNTY TAX ASSESSOR, 2L'S32~
Sl. lUC1E COUNTY, FIORIDA:
This is r.~y deciaration of ~om~cile and Citizenship in the Sta~e of Flo~ida that 1 am filing this day in accordance and
~n conformity with Chapter 222, Section 2?2.17, Florida Statutes.
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1 was formerly a legal resident of ~Q r~P,3~ F~~~ ~i .
(Ciry) (State)
and 1 resided at 3~l Ma y'/~-Q ~ _~T~ Nowever 1 have changed my domi~ile
(Street and Number)
?o and am and have been a bona fide resident of the State af Florida since ~ day of
//.Z! ~!_rr~_~ ~~~2 . -
~ , 19.? , and I reside at
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
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 ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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2(~,32~
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~ 1 FURTHER CERTIFY that I will comply with all other requirements of a(egal resident of this State.
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~ I FURTHER CERTIFY that t have no intention to return to my former domiule, and I intend to remain in FORT
s
~ PlERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ (Name)
~ .c~4'A?.rr~'s ~ . DE L o,y g~
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~ , (Address)
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_ . yirEi~n.,~..and subscribed before me this day of _ 19LL..
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- ' ~ ~ ,'~4Rr~s i
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'~-Y • , . ~ COURT
~ Notary Public
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- By l2 _ _ D.C_ My Commission expires
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- (To bs ~xecvt~d in dupliut~ and oriyinal filsd with Cl~rlt Ci?cuit Courf, and dupliut~ with Tax Ass~ssor.)
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° R 190 1655
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