HomeMy WebLinkAbout1720 Declaratio~ ot Domicile a~d Cltizenship ~ ~
TO THE STATE AND COUNTY TAX ASSESSOR, 2,~'yr~,~
Sl. LUCIE COUNTY, FlOR1~A:
This is my declaration of Domicile and Citizenship in the State of Florida that t am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of
(City) (State)
/ 7 '~'N ~ ,y ~
and 1 resided at _ 4-- However 1 have changed my domiCile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since L~_ ~_~L2~_ day of
- , 19 and I reside at ~"~'~~~~1~ ~~1~•~~- ~'~'~S'r~~
(Street and Number)
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FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence a~d domicile in the State of Florida.
- (Inse~t here any pertinent fads, suzh 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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RECORD y C~~CUIT.~~
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~ I FURTHER CERTIFY that I will comply with al) other requirements of a leyal resident of this State. '
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# I FURTHER CERTIFIf that I have no intention to return to my former domiule, and I intend to remain in FORT ~
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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_ ~~'••$vitoe~n''toiai~ subscribed before me this day of , 19~~
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ROdER POITRAS
r CLERK GRCUIT tOURT ~ Notary Public
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- By D.C. My Commission expires
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y" Ro b~ ~xscul~d in duplicaM snd ori~insl filed with Cl~ic Grwit Court, and dupliut~ with Tax Assessor.)
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