HomeMy WebLinkAbout1155 Oecla~atio~ ot Domicile and Citizenship
TO THE STATE AND COUNTY TaX ASSESSOR, 2~3~2 ~
Sl. IUCIE COUNTY, FLORIDA: '
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This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and ~
~n conformity with Chapter 222, Section 222.1 Florida Statutes. ~
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I was fo~merly a legal resident of ~ ;
~C~ty~ (State) T
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and 1 resided at _~v ___l!_ - 1~owever 1 have changed my domicjlt
(Street and Number)
to and am and have been a bona fide resideM of the State of Florida since _ 5~- _ day of
_ 191_~ and 1 reside at ~ -
(Street and Numbe~)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domici~e in the State of Florida.
(Insert here any pertinent fads, such as sale of properry or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
4~ a~-w ~i~l G ~O~
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. fILEO AM^ RECORDEO
jG1~~ ST.lt1CIC CJUNTY FLA.
IlO~~~ ~OITRAS
ClERR ~ ~::ll' ~OURT ~ ~
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i FE8 3 l 45 PH ~7z
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223~2'72
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~ I FURTHER 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 domicule, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ . ~ ~R rIl p~ame) ~1A!?a M
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; - „ _ (Address)
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~'Sv~p~n to ~a~?d subxribed before me this day of
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ROdER POITRAS ~
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CIRCUIT COURT Notary Public
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gy D.C. My Commission expires !
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(To b~ ~x~cut~d in duplicaro and ori~inal filed witl~ Cl~rk G~cuit Court, and dupiicat~ with Tsx I?ss~ssor.)
- ~~RK l~ f~?.~ 1~54
No. 13 ^
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