HomeMy WebLinkAbout2533 Declaration ot Domicile and Citizenship
;
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Sl. IUCIE COUNTY, FIORIDA.
This ~s my declaration of Domicile and Ghzensh~p in the State of Flonda ~hat 1 am filing th~s day in accordance and
n conformity with Chapter 222, Sect~on 222.17, Florida $tatutes.
~
1 was formerty a legal resident uf Seneca Falla Ner~_ YorY
~C;ty~ (State)
~
and 1 resided at Lake RoAd RD 2, H07C 324 _ Nowever 1 have changed my domicjle
(Street and Number)
~o and am and have been a bona fide resident of the State of Florida since 24th day of
No~esber , y9 ?1 , and I reside ar ~81 Tranquilla~i?enug PQ~~ St.I+uoie
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and th+s 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 dornicile, removal of family to ~ew domicile, purchase of home, etc.)
222~1'7
FIlEO ~h~ °EvOR0E0
T ROCEFC~~~R~S~A.
~L~.. r~iiRT /
: ~
rE~:rr
E ,1u~ Il IC ~s AH'~"l
; , ~ti.
} .
~ - ~
~ ,
; _ ~
i ;
~ ?
~
5
i
s
~
~
I FURT!!ER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
~
~
~ I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
~
?tERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ ~~7tC A~~~-
. - am - - -
~ , . ,~'Eiv
y ~~4 s
f~.P.se~Y
~-~3 ~ . 381 Tranquilla A~enue
(Address) r . uc e ~
Swom to end subscribed before me this _____I~t}l__ _ day of ____~~LLi8r.T----, i9-~2 ~
_ ~
= ROGER POITRAS _ }
- K CIRCUIT COURT Notary Public 3
~ ~
- By D.C. My Commission expires
~_k ±
_ ~
(To bs executed in duplicaro and origina! ~ilsd with Cl~rk Grcuit Court, and dupliuM with Tsx Assessor.) ;
x;
e 60CK ig8 PACE ~5~ ~
= ~b ~a
- _ - _
_ .
, :
_ - _