HomeMy WebLinkAbout2618 DeClaration of Dort~icile and Citisenship
TO TNE STATE AND COUNTY TAX ASSESSOR, '
Sl. LUCIE COUNTY, FLORIDA: j~~4W
This is my declaration of Domicite and Citizenship in the State of Florida that I am filing this day in accordante and
~n conforrnity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of~~~. ' _
(City) (Sta
and I resided at~ 1_~~ ~ / ~ . n m mi 'le
~___L~ However I have cha ged y do c.~
(Street and Number)
to and am and have been a bona fide resident of the State of Fbrida since 1_ L~1 _ day of ;
_ . _ - _ - - . 19~~, and I reside at Y ~ _ - _ .
~($t~t~d~u?pber) , . i
o~~.
FORT ~IERCE, SAINT LUCIE COUNTY, FLORIDA ~ 3~~~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domi~lTie ~1e of Florida.
(tnsert here any pertinent facts, such as sale of property or business, or reli~quishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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~io4ER Pa~ ~~s :
CtEO YE
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RECOa ~
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~ I FURTHER CERTIFY that 1 will compty with all other requirements of a legal resident of this State. ~
Y
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~ I FURTHER CERTIFY that I have no intention to return to my former domiCile, and I intend to remain in FORT
~
° PIERCE, SAINT lUC1E COUNTY, FLORIDA, permanently_
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= " S~~C~h `~me) ~de .c'PS /~e`'
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' - ~C . ~~65 ~P.~- /
- . ' (Address) a,e~ c~ ~ ~i~ , ~ -
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Sworn to and subscribed before me this day of ~j//.~i-~c~'' , 19 ~ 2
= ~
ROGER rORRAS ~
K CIRCUIT COURT / Notary Public ~
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' By ~-u~" D.C. My Commission expires ~
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~ Ro b~ ~x~cuhd in dup{icah a~ ori~inal fifed wi~h CINk Citatit Court, and duplieat~ wHh Tsx Ass~ssor.) j
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