HomeMy WebLinkAbout0743 Declaration of Domicile and Citisenship ~
TO THE STATE AND COUNTY TAX ASSESSOR, ~p~~~
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51. lUC1E COUNTY, FIORIDA:
This ~s my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and
~n conformity with Chapter ?22, 222.17, Florida Statutes.
I v?as formerly a legal resident of _ V1IICBritOwyi _ _ NBN? J@ri@1 _
(C;ty) (State)
and 1 resided at ~ 5 HOlly ~1Vd. _ However 1 have changed my domicjle
(Street and Number)
to and am and have been a bona fide ~esident of the State of Florida since ~ 2t~'1 _ day af
No~ember . , t9__ T1, and I reside a~ _?21 ~`u:~bli11 Kli31g RO~._
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual iegal residence and domicile in the State of Florida.
(Inserr here any pertinent facts, such as sale of property or busi~ess, or relinquishment of employment .
at former domicile, removal of family to new domicile, purchase of home, etc.)
Rozanne Evana ~0 ye~rs `
fIlEO ANp R!C RpEO ~
LT. lUC1E COUN~ FV,
Aridget Evana ~ 3 yeara CtERKCC
RCUiT c
u~T ~
, RECORO VERIFIEO~~~
t~ll 3~PM'TI
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~ 1 FURTNER CERTIFY that 1 will comply with sll other requirements of s leya) resident of this State.
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~ 1 FURTHER CERTIFY that I have no iMention to return to my former domicjle, and 1 intend to remain in FORT
~ ~IERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ ~~Li~s~^--~_~-4,a.~f-~~
(Name)
Y~
~ Violet Evana
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221 Tunblin Klin oad
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(Address)
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G' 1/ P 7~ c~--
Sv~lOr~ Ynd subKribed before me this
, day of , 19 _ . ~
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_ RO~IR ?OITRAI~_ ~ - - - -
(~K CIRCUIT.Ci~~1RT Notary Public
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By _ ~ D.C. My Commission expires
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(To b~ ~x~cut~d in dupliut~ and ori~inil ~il~d wiih CIKk Circ~it Courf, and dupliut~ wiN~ Tax Assessor.)
B~~K 197 ~a~f 743
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