HomeMy WebLinkAbout1236 Declaration ot Domicile and Citizenshlp
TO THE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE. COUNTY, FIORiDA: ~Zr~3329
This is my declaration of Domicile and Citizenship in the Sta~e of Florida that I am filing this day in accordance and i
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~n conformity with Chapter 222, Section 242.17, Florida Statutes. ~
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I was formerly a legal resident of .t~!? _l_ °i2__ - _ _ - - - -
~C;ty~ (State)
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and I resided at G~ Y1 _?'t_!' 4~'' e- However 1 have changed my domiGle 1
(Street and Number) ~
~o and am and have been a bona fide ?esident of the State of Florida since ~?-T_-_ day of
_4 n~t k•- , 19~'? and I reside at . ~J K y"~ r"? R ~
~7_0 - - ~
~ (Street and Number)/J ~ '
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FORT PIERCE, 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 domicile, purchase of home, etc.)
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F ?!LEO AN~ t~CpRp ~
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~ I FURTHER CERTIFY that I will comply with all other requirements of a lega) resident of this State. ~
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~ I FURTHER CERTIFY that 1 have no intention to retum to my former domiCile, and I intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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Swom to and subscribed before me this ~7~ - day of , 19
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= ROGER. DOI~tS
CtEYK CIitCU11' ~COt1RT Notary Public
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- By ~ ~ ~ 5 D.C. My Commission expires _
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- (Te~b~ ,Nt~oofed in duplicate and o?i9~0 R~'~ w~ ~l~rk Cirwit Court, and dupliuts with Tax Ass~ssor.)
_ - s~nK 199 1235
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