HomeMy WebLinkAbout2719 Dectaration ot Domi~ile a~d Citizanship
TO THE STATE AND COUNTY TAX ASSESSOR, 224381 ~
51. LUCIE COUNTY, FLORIDA: '
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This is my declarotion of Domicile and~Citizenship in the State of Florida that I am fili~g this day in accordance and ~
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I rras formerly a legal resident of .________GreeIIbB~_______ WISCOAEil1
(City) - - - - - ~fate)
and I resided at 1 E?OQ F8r1~11_A~@ . . _ However I have changed my domic,~le ~
(St~eet and Number)
24th
to a~d am and have been a bona fide resident of the State of Florida since _ day of
______I?_~C@IDb@l^_ _ 19~1, and I reside at _____'~08 _ South 2 th St • _ . _ _
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA
and this statement is to be taken as my declaration of citizenship, adual legal residence and domicile in the State of florida.
(Insert here any pertinent fads, such as sale of properry or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Homeatead - eat8blish residence
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S[.t~CIE COlht~
' ~I!lC6ER P~ .
'CLF,RI~ CIRCU~T' ~
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I FURTHER CERTIFY tfiat I will eomply with all other rsquirements of a te~al resident of this State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domiti~~, and I intend to remain i~ FORT
~ PIERCE, SAINT LUCIE COUNTY, FIORI~A, permanently.
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(Address)
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~ ~d~ar~d subscribed before me this 24th day of FebruarX , 19~_. ,
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~ `~y~ ~ ~ ~ ~ D.C. My Commission expires ~
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= (To b~ ~x~cvt~d in duplicah and ori~inal $bd wilh Cl~+ric Cira~it Cour~, snd duplicab with Tax Ass~swr.)
w~ ~ooxly9 PA~27~8
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