HomeMy WebLinkAbout0305 Declaration ot ~omicile and Citise~shlp
20645~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FIORiDA
This is my declaration of Dom~cile and Citizensh~p in the State of Florida that 1 am filing this day in accordance and
~n co~formity with Chapter 222, Section 222.17, Florida Statutes.
i was fo~merly a legal resident of _~~~9Q N14~f~~ A~• ~uv N~~/ 1_'~R !~~,l~~t_~l[~_
~ (City) ~ (State)
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and 1 resided at )G C~'~k(A~Jo~1 tl - . _ . _ _ . _ _ Nowever 1 have changed my domiCi~e
(Street and Number)
ro and am and have been a bona fide ~esident of the State of Florida since t~i _ _ day of
. ~e.t t 6 t'C~ , 19_?v , and I reside at _ ~t~ _~Q_~_Q %'bG -~25
(Streei and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FIORlDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert he~e 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.) '
206451 `
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Luc
E couNTY
ROQER ?OIT1tA=
• QIERK CIRCUIT OOIMT
ItECORO VERI?IED..,.~~
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
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~ 1 FURTHER CERTIFY that I have no intention to retum to my former domic,ile, and I intend to remain in FORT
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~ PIERCE, SAINT LUGIE COUNTY, FLORIDA, permanently.
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- , ' . , . r '~rs`.a'~ ' "
~ _ . James ~rd Boyle
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~ Sworn to and subscribed before me this day of _ _ , 19~ .
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P2 RO~iER POITRAS j
CIRC IT COURT Notary Public
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~ gy A_~E'2 D.C. My Commission expires
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~ (To b~ ~x~cut~d in dupliut~ •Rd ori~inal fil~d with Cl~rk Circuit Cour1, and dupliut~ with T~x Ass~ssor.) `
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