HomeMy WebLinkAbout1993 ~ f
Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FlOR10A: ~~9V6
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordarxe and
in conformity with Chapter 222, Section 222.17, Ftorida Statutes.
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I was formerly a legal resident of
(Ciry) (State)
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and I resided at __1 ~ ~ ~ ~J ~ / • 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 ~_Z~ day of
_ - _ - 19--, and I reside at -~L~e"~
(Street and Numbe~)
FORT PIERCE, SAINT LUCIE COUNTY, FLOft1OA
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 fads, such as sale of property or business, or relinquishment of employment
at forme~ domicile, removal of family to new domicile, purchase of home, etc.)
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~ I FURTHER CERTIFY that I will aomply with all ather requirements of a IeQal resident of this State.
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~ I FURTHER CERTIFY th~t I have no intention to return to my former domicjle, and I intend to remain in FORT
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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'~'~~itn~}~ subscribed befo~e me this day of , 19~a--
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ROQ~ER ~OITRAS
= CL~K CIRCtNT COtiR Notary Public
z~ By ~ D.C. My Commission expires ~
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= (Te b~ ~x~c+rt~d in d~rplic~at~ s~d o~ioiwal ~ihd w1N~ Cl~k C'iraiiR Cow~, and drp{e~ wiN~ Tsx Ass~ior.) #
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