HomeMy WebLinkAbout2239 Decla~atio~ ot Domicile a~d Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl . lUC1E COUNTY, FLORIDA: ~26~ ~9 ;
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was forme~ly a legal residen~ of !_!'__02TH Oc-.[C S7r'~> ~jr/iU
(City) - ` (State)
and 1 resided at °~~S__86 ~Y~t/NA r!~ ~t/ /J/Z, _ _ However I have changed my domiGle
' (Street and Number)
to and am and have been a bona fide resident of the State of Florida since day of
ScY~T ~O G' /~/2/3c12 /4vL v ' S~
- . _ , 19~__, and I reside at - - - -
(Street and Number)
FORT PIERCE, 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 Flo~ida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.)
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FILED 1?ND RECQ,R E0 l
tT. ~OCERCP01TR/~= ~
RK CIRCUIT COUIIT ~N~ -
CLE
RECORD YERtf1Ed..~..~~ -
1!~ 13 2 ~9 PN'Zt
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~ 1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
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~ t FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remain in FORT
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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' ~ " ~ • ; (Address)
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- ~,:•S~qm~to~~+d'subscribed before me this day of , 19~y
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ROGER POITRAS
CLERK CIRCUIT COURT Notary Public
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By ~ ~ _ O.C. My Comrnission expires
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~ Ro be ex~cut~d in dupliute and orisinal filed with CIKk Cirwit Court, a~sd duplicats with Tsx Assessor.f
aooK2~0 PacEz2"e~
t1o. 13 p
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