HomeMy WebLinkAbout1257 Declaration ot Dorniclle and Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR, 2~544'7
51. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformiry with Chapter 222, Section 2~2,17, Flo~ida Statutes.
1 was formerly a legal ~esident of e~'N .~[~G E'r/a~ E Df~io 'f~s/o39
(Ciy) (State)
and I resided at ~~.QL~CENTE~ /~iDGE /~d However I have changed my domiGle
(St~eet and Number)
yN
ro and sm and have been a bona fide resident of the State of Florida since day of
~EC F~ , 19~'L, and 1 reside at LQ?_/3 S. /o Sr"
(Street and Number)
PORT PIFRCE, 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 Horida.
(I~sert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former dumicile, ~emoval of family to new domicile, purchase of home, etc.)
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- 22544'~
fIlEO AND RECORQE~
ST. ~UCIE COUNTY il .
ROCER POITRAS
CIERK CIRCUIT CO
RECORD VER~FIEO i
~ I+~ $ 43 ~'7Z
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I FURTHER ~ERTIFY that I will eomply with all other requirements of a leqa) resident of this State.
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I FURTHER CERTIFY that I have no intention to return to my former domic,ile, and 1 intend to remain in FORT ~
AIERCE, SAINT LUCiE COUNTY, FIORIDA, permanently. '
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~ . Swarn to and subscribed before me this day of ~4G~~~' fl--~ , ~q 7.:Z_
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~ ROGER POITRAS
~ CLERK CIRCUIT COURT Notary Public
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~ BY ~ D.C. My ~ommission expires
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~ (To. b~ ~x~cut~d in dupliut~ and oriqinsl fil~d with Gerk Grwit Court, •nd dupliut~ witb Tax Ass~ssor.)
~ 0 R 'ZOO PRCE
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~ !+o. 13 A
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