HomeMy WebLinkAbout2059 Declaratlfln of Ddmicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, • ' ~~~Q~Q ~
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Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and ~itizenship in the State of Florida that I am filing this day i~ accordance and !
;n conformity with Chapter 222, Section 22~.17, Florida Statutes.
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I was fo~merly a legal resident of J~~~'-. -_L_.-L!
(Ciry) tate)
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and 1 resided at ~ i~~~~L r-Q~ - Howevef I have changed my domiGile
(Sireet and humber) _
to and am and have f+een a bona fide resident of the State of Florida since <a~~_ day of
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- , 19~~_, and 1 reside at _f~~ . ~ ~
(Streef an Number)
~T" ~.~P
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FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA
and this statement is 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, removal of family to new domicile, purchase of home, etc.)
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~ I FURTHER CERTIFY that I will cornply with all other requirements of a legal resident of thia State.
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~ I.FURTHER CERTIFY that I have no intention to return to my former domic~le, and I intend to remain in fORT
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~ PiERCE, SAINT:WCIf COUNTY, FIORIDA, permanently.
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= Sworn to and subscribed before me this day of - , 19.~~/ i
~ ROGER POITRAS
CLERK CIRCUIT COURT Notary Public
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By D.C. My Commission expires
= (To bs ~xeevted in duplieaM and ori~inal filed with Clrerlt Grcvit Court, snd dupfieat~ with Tax Ass~stor.)
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