HomeMy WebLinkAbout1446 Declaration ot Domicile and Citizenship
TO TNE STATE AND COUNTY TAX ASSESSC)R, ;
Sl. LUCIE COUNTY, FIORIDA ~`~zv~
This is my declaration of ~om~cile and Citizenship in the State of Ftorida that I am fil~ng this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes -
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1 was formerly a legal resideM of _ - -
(C~ ) (State)
and 1 resided at _ However I have changed my domiu~e ,j
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(Str~et and Numbe ) ~
to and am and have been a bona fide resident of the State o~ Florida since ~/J'y""' SJ _ _ day of
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(SYreet and Number)
fORT PIERCE, SAINT LUClE COUNTY, FtORIDA
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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 employme~t r
at fo~mer domicile, removaf of family to new domicile, purchase of home, etc.)
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~ 1 FURTHER CERTIFY that 1 will comply with all other requirements of a lega) resident of this State. i
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~ 1 FURTHER CERTIFY that I have no intention to return to my former domiCile, and I intend to remain in FORT j
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~ PIERCE, SAINT lUC1E COUNTY, FLORIDA, permanently_ f
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Swom to anc! sub;aibed before me this _ day of
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ROGER pO1TRA5 ~
CIERK CIRCWT COURT ' t~otary Public
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S- D.C. My Commission expires
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- (To b~ ~x~tvNd in duplicat~ and ori~inal filed witb tf~rlt Ci?cuit Court, and duplicats with Tsx Ass~s:or.) ~
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