HomeMy WebLinkAbout1074 Declaration ot Domicile and Citize~ship
TO THE STATE ANO COUNTY TAX ASSESSOR. 2 0 g 9 3 9
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Sl. LUCIE COUNTY, FIORIDA: ~
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This ~s my declaration of Oomicile a~d Citizensh~p in the State of Florida that I am filing this day in accordance ar~d ~
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~n conformity with Chapter 222. Section 222.17, Florida Statutes. '
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1 was formerly a legal resident of . _ _ _ _ _ _ _ - -
(City) ( tate)
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and I resided at _ _ _ . However I have changed my domicjle
(Street and Numbe~)
so and am and have been a bona fide resident of the State of Florida since _ day of
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_ ~ ~ , 191 and 1 reside at ~ o _ ~=LU~~~1 ~/if J _ ~_V~ . _
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
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, removal of famify to new domicile, pu~chase of home, etc.)
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FILEO AND RECQR~~~,
~t, ~1CIE COUIi~Y
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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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~ I FURTHER CERTIFY that I have no intention to return to my forme~'domi~ile, and I intend to remain in FORT
~ PiERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ (Name)
. Fra,ois J. G~A1 /1
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(Address)
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~ Swom to and suburibed before me this day of , 19~_.
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- ROGER ~QI~AS` ~~~~/ii . - -
C 'Cf~}~T'%, Notary Public
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> By _ D.C. My Commission expi~es
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~ (To 6~~IJt '..iN,~4~k~ and ori~insf til~d with CI~?k Cirwit Couvt, •nd dupliut~ with Tax Ass~ssor.)
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~ ° R 191 1U72
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