HomeMy WebLinkAbout2878 Deciar~tio~ ot Domtcile and Citizenship
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TO TNE STATE AND COUNTY TAX ASSFt~[~Q _~~~v ~
Sl. l!le1ECOUNTY, FLORIDA:
This is my dectara
on of ~omicile and Citizensi~ip in the State of Florida that 1 am filing this day in accordance and
~n conformity with Chapter 222, 5ection ?22.17, Florida Statutes.
I was formerly a legal resident of _ .
(C+ty) (State)
I
and I resided at 3? y However 1 have changed my domi~ile
~ (Street and Number)
to and am and have ~een a bona fide resident of the State of Florida since s~..~ day of
+
S(~/ NF , 19~ a~d 1 resid~ at -~L~~
treet d Numbe~)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domici~e in the State of Ftorida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former dornicile, removal of family to new domicile, purchase of home, etc.)
TO ESTA~LICH RESIDENCE AND IIdTER CHII,D IN SCHOOI,
~348~6
JEFFREY D~YANE SPECK Age 13 .
' o .,ro ~fcoR
s~ine,~ caur~r ~
ROCER PbltitAS ~
. CIERK CI:iG01T COURT
RECORO V£kiFiEO.~...~,~.,.
Atie 1 10 s61H'11
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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 domirjle, and I intend to remain in FORT
~IERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. jy~pRy E. SPECK
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~ (Name)
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11~''~ ~~'~G~'~.
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r~ ~~scribed before me this day of , 19~-~
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~ OG~R~~i g . .
~ ' ' ~ ~K'Cl~t~tOURT Notary Public
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By D.C. My Commission expires
(To be •xecuted in duplicate and original filed with Clerk Circuif Court, aed duplicate wilh Tsx Assessor.)
aoox 204 Pa~t-2877
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