HomeMy WebLinkAbout0456 Deciaration ot Domlcile and Citizenshlp
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TO THE STATE AND COUNTY TAX ASSESSOR, i
51. LUCIE COUNTY, FIORIDA ~
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Th~s ~s my declaration of Domiale and C+hzenship in the State of Florida that I am fil~ng this day in accorda~ce and ±
~n conformity with Chapter ?22, Section ?22.17, Flo?ida Statutes ±
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I was formerly a legal res~dent of Flora P~rk L. I. ~gW_ ~Q~]C_
(Ciry) (State?
and I resided at 91 TUl~p AV@ _ _ However t havechanged my domiC+le
(Street and Number)
~o and am and have been a bona fide resident of the State of Florida since 4t~'1 day of
No~ember ,~9_71 , and I reside at _ Rt 4 Box _ 241 _
(Street a~d Number)
~QT p~FQCE, SAINT LUCIE COUNTY, FLORIDA
and this statement ~s 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 sale of property or business, or relinquishment of employment
at former domicile, removat of famify to new domicile, purchase of home, etc.)
E Entering children in a chool 2188~6
FIlEO aN0 REC R~[ f
i 5T- ~uc~e couw~r ~t~. ;
oc~a poirR~s ;
~ CIERK C~RCuIT ¢pyRT
RECORO VERIFIEO~~~
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1 FURTHER CERTlFY that I wili comply with all other requirements of a leyal resident of this State.
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r I FURTHER CERTIFY that 1 have no intention to retum to my former domi~ile, and I intend to remain in FORT
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~ PIERCE, SAINT.,~UCIE COUNTY, FLORIDA, permanently.
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• . . . ,.~l~sa~~~~-~~.~ / - - -
_ ~Pdame)
= " ~ Sandra Marcello
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. (Address)
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~ Swom to and subscnbed before me this _ ._1~Lh day of _=~OYembeT ~q_~ .
ROGER POITRAS
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_ C1~RK CIRCUIT COURT Notary Pubiic
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; BY _ _ - - - D.C. My Commiss~on expires ~
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~~s (To bt ~x~cut~d in dupliute and ori~inal fil~d with Cl~rk Ci?cuN Court, a~+d dupliut~ with Tax Ass~ssor.)
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