HomeMy WebLinkAbout0624 Declaration ot Domicile and Citlzenship ti148
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TO THE STATE AND COUNTY TAX ASSESSOR, .
51. IUCIE COUNTY, FlOR1~A:
This is my declarotion of Oomicile and Citizenship in the State of Florida that 1 am filing this day in actordante and
in conformity with Chapter 222, Section 222.17, Flo~ida Statutes. ~
1 was formerly a legal resident of aaCA06 _ ~F,W `lOAK _
(City) (State)
_ 4
and 1 ~esided at _2~~ _ MA11~ S~R~F~C Howeve~ 1 have changed my domi~ile
(Street and Number)
nd
to and am and have been a bona fide ~esident of the State of Florida since ~ _ day of
t~3Z4~y--- , 19~L, and I reside at 919
~Ll1EF'~SN ~01SR'Y -~Oa"C ~~6RC6~--
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FtORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert he~e any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
'~Amm~ ~EAt~t tY1~~GAYE ~o
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~~C?E G4UNtY f l~?~
IIOCE~ FOItAAS t~,.
CIE~
YE~
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EO C0U111
, IIECOa
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i Aua ~ti 9''a
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I FURTHER CERTIFY that I will comply with all other raquirements of a le~al ~esident of this State.
I FURTHER C:E~t11FY that I have no intention to return to my former domicjle, and 1 intend to remain in FORT
?IERCE, SAINT LUCIE COUNTY, FLORIDA; pe~manently.
- .
T
(Name) Gary Fobert Milgate
9~9 t~l.,u~~'•~ Cow?1r
„ .
~ ; ~o~Jr ~i ul~cv _~'1o~ud~a,
:~s :
• f. (Address)
~
r: Sworn tp end~3~bscribed befo~e me this °1 ' r day of 19~.
~.,i ~
d,~' ~
. 1 ~ ~ -
~.GIR IT COURT Notary Public
8y .C. My Commisaion expires
. ~ - ~
(To b~ ~x~eut~d in dupliut~ and oripinal Al~d with Cl~ric Cirwh Cou~, and dupliufa with Tax bs~sw?.)
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