HomeMy WebLinkAbout2189 2zs1.14
Declaration ot Domicile and Citizenship ~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FIORIDA:
This ~s my declaration of Oomicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
~n confo~mity with Chapter 222, Section 222.17, Florida Statutes.
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1 was fo~merl a I al res~dent of 1-
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Y e9
(City) (State)
~/~l-~'`i-- -J~- 4~-----._ . However I have changed my domicile
and I resided at _ _
(Street and Number) i
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ro and am and have been a bona fide resident of the State of Florida since _ day of
t-~e `
- _ - ~ _ 19~~ _ and f reside at --~G C^- _ -
' (Street and Number)
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FART PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in ihe State of Florida.
(tnsert here any pertinent facts, such as sale of property or business, or relinquishme~t of empl~yment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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. 2261.14
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal r~sident of this State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remain in FORT t
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~IERCE, SAINT LUGE COUNTY, FLORIDA, permanently.
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' ~ (Name)
~ ~ Eugene S Royal
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Swom ro and subscribed before me this _'z~ ~ day of //1~~'~__ , 19~~'
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ROCER POITRAS
LERK CIRCUIT COURT Notary Public ~
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~y By D.C. My Commission expires
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~ (To be executed in duplicate and original filed with CIKk Grcuit Courf, and dupliwte with Tax Assessor.)
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