HomeMy WebLinkAbout1230 Declaration ot Domicile and Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Sl. LUCIE COUNTY, FLORIDA:
2233~4 ~
This is my declaration of Oomicile and Citizenship in the State of Florida that I am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
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I was formerly a legal resident of _ ~ _ -
(City) (St e) ~
~ q' 7 D ~ Ca?-~c.~ C~~ /L. ~
a n d 1 r e s i d e
d a t - 1 n ~ H owever I have chan ged m y domi Gle
(Street and Number)
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to and am and have been a bona fide resident of the State of Florida since ~ _ day of
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- - - ~~N , 19~/_., anc! I reside at - - -
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(Street and Number)
PORT PIERCE, SAINT LUCIE COUNTY, FLORIOA
and this statement is to be taken as my declaration of citizenship, actval legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of praperty or business, or relinquishment of employment
at former domicile, removal of family to new domicile, p~rchase of home, etc.)
FR,E! ~CQ~E~
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ROCi Y F"tTRAS
tiE?X ; ' ~~3t i COUIIT '
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FEe ~I 2 ss PM '71
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E 223~24
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~ I FURTHER CERTIFY that I will comply with atf other requirements of a legal resident of this State.
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1 FURTHER CERTIFY that I have no intention to return to my f ine domi~ile, and I intend to remain in FORT ~
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~ ~
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~ (Name) ~/j/~ G ~
`r i • KNei J ~
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Swo(ri to~ahd suascribed before me this ~ day of , 197Z. ~
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R06ER PO~Y~CMi 1
CLERK CIRCU~TCOURT Notary Public ~
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By - - i ~ S D.C. My Commission expires
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(To b~ ~x~coted in dupiicate snd originsl filsd with Cl~rk Circuit Court, snd duplicat~ with Tax Ass~ssor.) ~
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