HomeMy WebLinkAbout2279 Declaration ot Dorniciie and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domiciie and Citizensh~p in the State of Florida that I am filing this day in accordance and
~n conformity wilh Chapter 222, Section 222.17, Florida Statutes. '
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1 was formerly a legal resident of _ -
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;ty~ (State)
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and I resided at ~~_Q 3 . However I have changed my domicjle ~
(Street and Number) ~
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to and am and have been a bona fide resident of the State of Florida since Y 2
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, and 1 reside at
(Street and Number)
fORT PIERCE, SAINT lUC1E COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Ftorida.
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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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~ 1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to retum to my former domiule, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORlDA, permanently. ~
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Sworn to ati"~;subscribed before me this day of . 19 - ~
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k0~6h~l~ITRAS -
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«M; CLERK ~IRCUIT COURT Notary Public ~
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~ By C~N D.C. My Commission expires ~
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(To be executed in dupliute and originsl ~iled with Cl~rk Grcuif Court, and duplicate with Tsx Assessor.)
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