HomeMy WebLinkAbout0750 Deciaration ot Do~nicile and Citis~nship
TO THE STATE AND COUNTY TAX AS`,ESSOR,
Sl. IUCIE COUNTY, FLORIDA: ~1~p8~
This ~s my declaration of Oom~cile and Cit~zensh~p in the State of Flo~ida that 1 am fil~rtg this day in accordance and
~n conformiry with Chapter 222, Sec~ion 222.17, Florida Statutes
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I was formerly a legal resident of ~l-1 ~L~~U~-~i2--- -
(City) (State)
and I resided at y~ LC ~c~ ~c:Ztc.~.r2Gi~_ ~Y-~ However I have changed my domicule
(Sireet and Numbe~)
?o and am and have been a bona fide ~es±dent of the State of Fiorida since ~~~Zt.~ day of
, i 9. ! and I res~de at ~J / ~j _ ~mi~ !-f~' c~ ~,~/Q i
(St~eet and Number)
FQRT PIERCE, SAINT lUC1E COUNTY, FLORIDA
and this statement is to be taken as my dectaration of citizenship, actual lega! ~esidence and domicile in the State of Florida.
(tnsert he~e a~~y pe~tinent facts, such as sale of property t;r business, or relinquishment of employment . ~
t
at former dornicile, removal of family to new domicile, purchase of home, etc.)
i~ ~n~~i t:-w i~ ~ 21288z
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C-`7 J~~~c--~"y~ _ FIlEO AMD ttECpROEe
~ ~ SL WCIE COUNTI? ftA.
ROCER POIt~At
- % ~~2 ~.L , ~ J . CLERK GRCUIT COURT
~ RECORO YER~FIEO~.,~~
' Jui1l IOssAM'11
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I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this Stat~.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, 'rLORIDA, permanently.
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t ' . . . ~~G~'~,1-~~ _ ~
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~ • • (Narr~e) ~
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3 - _ I,ouise F Curr~ ( Mra l~arion )
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rSwtfrA to and subxribed befoce me this day of _ - _ , 19~.' ~
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~ ROGER POITRAS - -
~ ~CLERK CIRCUIT COURT Notary Public
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~ By~~`''~'~'~'___ D.C. My Commission expir~s
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(To be ~xscuted in duplisate and orig~nal filed with Cleric Circuit Court, and duplicate with Tax Assessor.)
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