HomeMy WebLinkAbout2006 Declaration ot Domicile and Citizenship
TO THE STATE AIdD COUNTY TAX ASSESSOn^, 236449
51. IUCIE COUNTY, FtO~Ipn
This is my declaration of Domicile and Citizenship in the Sta~e of Florida that 1 am filing this day in actordance and
~n conformity with Chapter 222, Section 2?2.17, Florida Statutes. ~
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1 was formeriy a legal resident of ti..~Q(,(i_ _ _ ~~?-!V_Q,~ ~~h-~/1CJd1--~--- -
(City) (State)
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and 1 resided at However I have changed my domiGile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since _ day of
'
- - 19~~, and I reside at -N--~-
(Sire and Number)
FORT PIERCE, SAINT lUC1E COUNTY, fLORIDA
and this statement is to be taken as my declaration of citi2enship, actual legal residence and domicile in the State of Florida.
(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_)
Applying~ for Homestead
Entering children in school : ~
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R~ci€ ca~M~r
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I FURTHER CERTIFY that I will comply with all other requirements of a lega) resident of this State.
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I FURTHER CERTIFY that 1 have no intention to return to my former domiCile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. PATRICIA J. WKINS
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~N~ S~vam•to ana,~scfibed before me this day of _ , 19_L~
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RO~` ~R ~O~'TRAS - - - -
LERK RCUIT COURT Notary Publit
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[3y ...l~ ~-s- D.C. My Comrnission expires
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~ (To be executed in duplicate and original fited with Clerk Circuit Court, and d~plicate with Tax Assessor.)
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