HomeMy WebLinkAbout2485 ~ Deciaration ot Domicile and Citizenship
TO THE STATE AND CC~UNTY TAX ASSESSOR. 2%~4223
Sl. LUCIE COUNTY,.FIORIDA:
This is my declaration of ~omicile and Citizensh~p in the State of Florida that I am filing this day in accordance and
~n conformity with Chapter 222, Section 222.11, Florida Statutes.
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I was forme~ly a legal resident of ~ ~eu',
(City) (State)
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and I resided at ~ ~ '~-~~^!v~e _ /QS . ~ Nowever I have changed my damicile
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(Street and Number)
ro and am and have been a bona fide resident of the State of Florida since y`~=Cr ~~j _ day of ~
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~ 7~ ~ .c F,e~ _ • P ~ sr .c ~ ~ ?
~ ~ . 19--- ` , and I reside at _ _ ~ _ ~~•L'~- c~
(Street and Num~er)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and dom~cile in the State ot Florida.
(Insert here any pertinent fatts, such as sale ot property or business, or relinquishment of employment
at forme~ domicele, remova~ of family to new domicile, purchase of home, etc.)
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E 224223
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~ I FURTHER CERTIFY ihat I will mmply with all other requirements af a legal resident of this State. ~
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~ I FURTHER CERTIFY that I have no intention to return to my former domiGile, and I intend to remain in FORT
~ PIERCE, SAINT IUCIE COUNTY, fLORIDA, permanently.
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' .I ~ _ c~C- ~ C~. .G UC E'~if'fi - ~'/'~.j1~ L~/l'/ ,P.
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~ Sworr~'+t~.~Ad subscribed before me this ~ day of v _ - 19 7 1i ~
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ROGER POITRAS -
CLERK CIRCUIT COURT Notary Pubiic
By \ T~S` _ D.C. My Commission expires _
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f r (To b~ sx~cuted in duplicate and ori~inal fil~d with Cl~rlc Circuit Court, and duplicats with T~x AssestorJ ~
; „ A aooK 199 P~~2484
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