HomeMy WebLinkAbout1487 Oeclaration ot DomiCile and Citizenship
TO THE STATE AND COUN~Y TAX ASSESSOR, ~~SV~~
Sl. LUCIE COUNTY, FIORiDA:
This is my decla~ation of ~omicile and Gitizenship in the State of Florida that I am filing this day in accordance and
~n conformity with Chapter 22Z, Section 222.17, Florida Statutes. 3
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I was formerly a legal resident of ___-_S~~-1/rJ// - /`~s~/ f"r"
;ty~ (State)
and I resided at -_.L__~~~0lZ_~~~' Howeve~ I have changed my domic,~le
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since y~~~~~~` ---1~--~~~~day of
- . 19 and I reside at ' G~ ~Q.~ O I7 ~~O/'CCZ. ~1/~
(Street and Number) ~
FORT MERCE. SAINT tUC1E COUNTY, RORIDA ~
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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I RIRTHER CERTIFY that I will comply with all other requirement: of a leyal resident of thia State.
I FURTHER CERTIFY that I have no intention to return to my former domiCile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, perma~ently.
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(Name)
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~ ~ ~Sworr~ tqatlc~.~uburibed before me this day of
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~ ` ~.~OITRIIS
~ CiFRi( CIRCUIT COURT Notary Public ~
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gy C D.C. My Commission expires ~
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