HomeMy WebLinkAbout0874 Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FIORIDA:
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.
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1 was formerly a legal ~esident of ~~~_~Q~~__ J~----
(City) (State)
and I resided at - . Howeve~ I have changed my domiCile
(Street and Number) ~
to and am and have been a bona fide resident of the State of Flo~ida since 1__ __r _ day of
I1~E _ _ _ _ _ 191.~; and I reside at __L_~L( A ~ V l ~ ~ '°~-~'~E~ ~
_ _ . (Street and Number) ~D12T S %
.
PORT PIERCE, SAINT LUCIE COUNTY, FLORIDA Lu C/~
and this statement is to be taken as my decla~ation of citizenship, actual legal residence and domicile in ihe State of Florida.
(Insert here any pertinent facis, 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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~ ~ f ~ED ANO RECORpEO
~ i~. LUCIE COUNTY FIA.
R6CER POITRAS
i CIERlI CIRCUIT COURt. ~
~ RECOR~ YERIFIEQ~,..~
Jw, Il 3
1 FURTHER CERTIFY that I wi~l comply with al! other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. JOA:'?I+TE M. SESSA
~ (Name)
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~ `~`yi~~e~ r (Address) ,
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~ r 'bed before me this day of , 19
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:
CO T - Notary Public
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By D.C. My Commission expires
(To be executed in duplicsfe and original filed with Clerk Grcuit Court, and dupliute with Tax Assessor.)
~ 8001(~~ ~JN;E
No. 13 A
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