HomeMy WebLinkAbout2552 Oeclaration ot Domi~ile a~d Citizenship
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TO THE STATE AND COUNTY TAX ASSESSUR,
51. LUCIE COUNTY, FIORIDA:
This ~s my declaration of Oomicile and Citizenship in the State of Floride 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 .~~U - - -
(Ciry) (State) :
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and I resided at _~~4]._ O~D~__._ _~1_:_ However I have changed my domiGi~e
(Street and Number)
ro and am and have been a bona fide resident of the State of Florida since ~U . 19~-~ - _ day o!
, 19_ and I reside at a 1~_~~-~m Q~ ~l~"
(Street and Number)
FORT PIERCE, SAiN? LUCIE COUNTV, FLORI~A
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. ~
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(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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ROCER'OITII~S
CLERIC CIRCUIt COtIRt
RECORQ YERIf1E0.,.`+ ¢
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~ 1 FURTHER CERTIFY that I wil) comply with all other requirements of a legal resident of this State. _
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~ I FURTHER CERTIFY that I have no intention to return to my former domiG+le, and I intend to remain in FORT }
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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Sw m t and subscribed before me this da of . 1q~Z
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- ROGER POITRAS - - 3
K CIRCUIT/ ~COURT Notary Public ;
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_ By D.C. My Commission expires -
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(To bs execut~d in dupliwt~ and ori~inal filed with CI~?k Circuit Court, and dupliute with Tax Ass~ssor.) '
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~~V ° R 1yy ~~~E ~551
- 800K
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