HomeMy WebLinkAbout0257 - Decla~ation of Domi~ile and Cttizenship 2i ~~)r~r~
TO TF1E STATE AND COUNTY TAX ASSESSOR,
Sl lUC1E COUNTY, ftOR10~>
i~:is +s my dec~aration ot Oom~ule and Citizensh~p in the S/ate of Florida that 1 a-n f~ling this day in acco~dance and ~
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~n conformity with Chapter ?2~, Section 722.17, Florida Statutes. ~
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I was formerly a legal resident of 1 ^~VL/~~ Y~ ~r ~R t ~!!I ~
(City) (Sfa?e) ~
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~nd 1 res+ded et JY• 1~~ ~ O~~ 4 G~lR f C3 3 3 f 3 J However 1 have changed my domiC4~? ~
(Street and Nvmber) ~
to and em and have been a bona fide resident of the State o1 Florida since x~ day of ~
~.../~11~• ~ , 19.~0 7 , and I ~exide at ~9 Svl~ll~~ ~o(/!~~/~ ~ ~
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(Streei and Number) s
FORT PIERCE, SAINT LUCIE GOUNTY, FLORIDA ~
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and this statement is to be taken as my declaration of citizenship, acfual legal residence and domicile in the State of Florida.
(Inserl here any pertinent facts, such as sale of proFerty or business, or relinquishment of employmen~
at former domiciie, removai of family to new domicile, purchase of home, etc.)
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Eatablishfng residence ~
Appl;~ing for homestead
Entering c2:ildren in school
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LI~ICIE COUi1tY ~
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RECORO YERqf1E0 C~T
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F 1 FURTHER CERTIFY that 1 will comply with al) other requirements of a legal resident of this Sfate.
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~ t FURTHER CERTIFY that I have no intent6on to return to my former domi~ile, and 1 intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLGRIDA, permanently_
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~ - ~N e) Americua . Pierantozzi
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_ (Address)
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# Sworn to and subscribed before me this 2Oth day of _Jul~ , 19 ?
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~ ROGER PORRAS - - - ~
~ tIFItK CIRCUfT C _T,~=~• ~ ~ - Notary Public `
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~ aY ~ - _ ~1,C. My Commission expires
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~ (To be executed in dupliuti anc}~.`p~~nsl filed with Gerk Circuit Court, and dupiiute with Tax Assessor.)
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