HomeMy WebLinkAbout2141 De~laration ot Dorhicile and Citizenshlp
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is niy deciaration of Dom~cile and Cit~zensh~p in the State of Florida that 1 am filing this day in accordance and
;n conformity w~th Chapter 22?, Sect~on 2~2.17, Florida Statutes.
I was formerly a legal resident of ? 4%~ S(~_ _-L~_.__ :
(City) ~ (State) S
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and I resided at 3 Qq . However I have changed my domi~ile
~v~:~~~ 3~.~1 Al~~m{~Pr1
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!o and am and have been a bo~a fide resident of the State of Florida since day of
N o~ ~m be~ , 19_7~ , and I reside at ~~~9_~21.1 GL~ ~ 1--~- v~'~' ~
(Street and Numbe
FORT PlERCE, SAINT LUCIE COUNTY, FLORIDA
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 domi~ile, purchase of home, etc_)
221936
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FILEO 1?KD RECOR E
St. LUC1E C~UM1r
RCC~~ r~tiRAS
CIERK C' :CUlT COUR~
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~ I FURTHER CERTIFY ihat I will comply with all other requirements of a(egal resident of this State.
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r I FURTHER CERTIFY that I have no intention to retum to my former domic,ile, and 1 intend to remain in FORT
? PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently.
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=y Swom to anQ subscribed before me this ___1_~___ day of - , 19,
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ROCER rOITRAS - - - -
- .~LERK C CUIY COUR Notary Pubiic
Byl~~~ S- D.C. My Commission expires
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_ (To be ~xecuted in duplicste and original ~ilsd with Cl~rk Grcuit Court, and dupliute with Tsx Assessor.)
, 3 BooK 198 F~~~ 21~8
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