HomeMy WebLinkAbout2398 Declaration ot Domicile and Citizenshlp
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA: ~~O
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This is my declaration of Oomicile and Citize~ship in the State of Florida that I am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Floride Statutes.
I was formsrly a legal resident of _ -
(Ciy) ~ (State)
~ -
and I ~esided ~at __~C! _ _ _ _ _ _ . _ . However I have changed my domiCile
(Street and Number)
to and am and have been a bona fide ~esident of the State of Florida since X" L-e'Z- - day of
1, tidt.iL~!~~'~ 19~ , and I reside at ~~2-. ~C~7i~L ~ !1~/ L - - -
(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 Florida. ~
(Insert here any pertinent facts, such as sale of prope~ty or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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~ I 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 return to my former domicjle, and I intend to remain in FORT ~
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~ PfERCE, SAINT L11~. COUNTY, FLORIDA, permanently. ~ ~
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:pr` "s (Name) o ; P~ ~
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= Swom to and subscribed before me this ~ l day of C~'i~~~~ ~-c'-~~ , 19 ;
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' ROGER POITRAS ~
CLERK GIRCUIT COURT Notary Public ~
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_ By «<t~ ~ 1h`r~`-~ D.C. My Commission expires i
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- (To be oxecuted in duplicst~ snd ori~inal filed with Cbrk Grcvit Court, and duplicate with Tax A:sesaor.) ~
- OR~y~ s~ ~
No. 13 A 600K ~W PACf iGJ97
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