HomeMy WebLinkAbout0521 Declaratio~ ot Dom~cile and Citizenship
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TO THE STATE AND COUNTY TAX A~SESSOR.
;i IUCIE COUNIY, FIORIDA
Tn~s is r»y ~eclararor. of po~~~iuie ar.d C~t~zensh~p in the State of Florida that 1 am t~i~ng this day ~r. accordance and
coniorm~ty witn Cnaprer t~~. `ection ??2.17, F~orida Statutes
I wa~ formerly a leya~ res~dent of ~~~B
(City) (State?
~i9N e yC ,~-~oC~ _ '
~-,d 1 res~ded ar 3'33 / However I have changed my domicile ~
(Street and Nun,ber ~ #
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•o and am and have been a bona fide resident of the State of florida since ~~e~~ /t~ day of
19_ ~f ~/~//e!l-SS- - f~ L Y~ ~
. and 1 reside at
(Street and Number)
f
S
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
snd th~s statement ~s To be taken as rny declaration of citizensh~p, actual legai res~dence and donuc+te in the State of Florida.
(Insert here any per;,nent Iacts, such as safe of property or business, or relinquishment of employment
at former domicife, remova! of famiiy to new domicile, pu+~hase of home, etc.)
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FIlEO Ay~ RECOADEO
ST. LUC~E COUNTY FU.
ROCEa aO~TfIAS
ClE~K. C ~U>T COURT
RFCCP.~ Yr~ F~EO
' JaN t8 10 so AN'~2
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~ I FURTHER CERTIFY that I will comply with all other requirernents of a legal resident of this State.
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~ I FURTNER CERTIFY that I have no intention to return to my former domi~ile, and I intend to remoin in FORT
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~ Y~ERCE, SAINT LUGE COUNTY, FLORIDA, permanently.
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~ _ - _ /,3i._~.~r~!• -~~v~-r
~ . . (Name)
- Bar tolo Alvarez
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~ ~ . ?~~N-~'/~-/~~~ j3~v~
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~ % (Address) /'~•s r rr ~
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r, Sworn to.and subscr~bed before me this _ day o ~`~yu~'~" , 19,~_2~
>z
" ROGER POITRAS
RK CIRCUIT COURT Notary Public
,
~ By _ D.C. M Commission ex ires
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J-~; (To be executed in duplicate and original filed with Clerk Circuit Court, and duplicate with 7ax AsseswrJ
- gooK 199 PACE 520 - ~
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