HomeMy WebLinkAbout0945 Declaration ot Domicile and Citizenshlp
TO TNE STATE AN~ COUNTY TAX ASSE550R, 16+Vp~~
Sl. lUC1E COUNTY, FlOR1OA:
This is my declaration of pomicile and Citizenship in the Stata of Florids that 1 am filin9 this day in acco~dance a~d
+n co~formity with Chapter 222, Section 222.17, Florida Statutes.
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1 was formerly a le~ga) resident of1i+.~r.(~lrtY'~~~~ --.____~'-l~C.-------. ;
~C~y~ (State)
and 1 resided at _~lCp- ~~l~iX~~ However 1 have changed my domi~ile
(Street and Number)
1o and am and have been a b~na fide resident of the State of Florida since .1~ l~ ~ day of
- 19SE9 , and I ~eside at i/ v ~/S.~ - -
(Street and Number)
FORT r1ERCE, SAINT LUCIE COUNTY, RORiOA ~
and this statement is to be taken as my declaration of citizenship, actual legat residence a~d domiciie in the State of Florida.
(Insert here any pe~tinent facts, such as sale of property or busi~ess, or relinquishment of emptoyment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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- F~LEO ~NO REC R ~
st wc~E couM~r ~
ROCEF POI?RAE C~
CLER~ CIRCUfT COWIT
NECORO YEIlIF1E0
MUur 1 !I ~ 1M'TI
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~ I FURTHER CHtTIFY that I will oompl with al) other r uirements of a leyal resident of this State.
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I FURTNER CERTIFY that I have no intention to return to my former domic,ile, and 1 intend to remain in FORT
PfERCE, SAlNT ~~~COUNTY, FLORIDA, permanently.
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~;~'r''.;, ' Frank 8 Cowan
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~ Swom t0 and sa~bscribed before me this - day of - . 19 - ~
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Roc~ romiws _ - -
~ , `~LERK GRCUlT COURT Notary Public ;
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B __v~ O.C. My Commission expires ~
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~ Re b~ ~:~cut~d in dupliub and o~i~inal ~il~d will~ C~rk Grcuit Court, and duplical~ witb Tuc A~sa~or.)
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