HomeMy WebLinkAbout0190 ~eClaratio~ ot Dor~icite and Citize~ship
TU THE STATE ANO COUNTY TAX ASSESSOl2.
51. lUtiE COUNTY, FLORIOA ~ir12r)Vt7
This ~s my ~.~eciaration ot Domicile an~ Citizenship in the State ut Florida that 1 am filing th~s day in accordance and
m confarm:ry with Chapter 222, 5ect~on ??2.17, Flor~da Statutes.
I was fo~merly a legal resident of /~.C1.B~!?.~'1'~~t.J 9~~!Ll~G~J
~C;ty~ (State) ~
and 1 resided at ~?C ~LQ/t4 (~C~- - However i have changed my domi~ile
(Street and Number3
!o and am and have been a bona fide resi~ent of the State of Florida since %~~~'LGL~. day o+
7~j~~i/ , 19_7~ , and 1 ~eside at .~0.3 /1G~. _
(Street and Number)
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FORT PIERCE, SAINT LUZIE COUNTY, FIORIDA
and this ssatement 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 sate of property or busi~ess, or ~elinquishment of employment
at former domicile, rernoval of fa~n~ly to new domicile, purchase of home, etc.)
Establishing residence
Applying for homestead
Entering children in school
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I FURThcR CERTIFY that I will comply with all other requirements of a legal resident of this State. '
1 FURTNER CERTIFY that 1 have no intention to return to my former domi~ile, and I intend to remain in FORT :
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PiERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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~ . . ~ 'Sworrf_!~'~fi~su~bsc:ibed beEore me this - - - - - - day of - ~ • 19-- i
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y'%~;.,C~i~RIF i~UIT COURf, Notary P~btic
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~ gY _ " - ~Q-- D•C. My Commission expires - - - -
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~ (To be sxecuted in dupiicate and original filed with U~rk Circuit ~ourt, and duplisate ~riith Tax As~essor.)
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