HomeMy WebLinkAbout1288 Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Oamicile 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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1 was formerly a legal resident ot _ . - _ - - L.l ~
(Cityl (St ) ~
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and 1 resided at However 1 have changed my domiCG~e ~j
(Street a~d Num ;
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to and am and have been a bona fide resident of the State of Florida since / _ day of
- - _ ~ _ _ , 19_~ l , and I reside at ~ ~ ~ - - _ . _
(Street and umber)
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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fIIED ANO RECOROEO
ST.IUCI~ ;.~U11TY FLA. ~
ROC:"' ~~iT~AS
CIERK C•'"~CtltT CC?URT `
REr,~s^ vfa~F~~J~
FEB 7 24 {~'ZZ
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w I FURTHER CERTIFY ihat I will comply wifh all other requirements of a legal resident of ihis State. ~
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~ I FURTHER CERTIFY that I have no intention to return to my former domicjle, and 1 intend to remain in FORT ~
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PIERCE, ~1~ COUNTY, FLORIDA, permanently. !
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Swom to and subscribed before me this _ day of , 19~L~ ;
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ROGER POITRAS _ _ ;
` K CIRCUIT COURT Notary Public ~
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By 1~ D.C_ My Commission expires _ ~
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(To bs executed in dupiicate and original filed with Cierlc Grcuit Court, and duplicate with Tax Assessor.)
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