HomeMy WebLinkAbout0181 Deciaration ot Domicite and Citize~ship
. 2,3'7408
10 THE STATE AND COUNTY TAX ASSESSOR, ~
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformity with Cliapter 222, Sectio~ 222.17, Florida Statuics.
. „
1 was formerly a legal resident of h_ t~_~!~_L~_-_____ - j
(City) (State)
and I resided at ~=_L//5/_1~~.~___ However 1 have changed my domiCile
(St~eet and Number)
to and am and have been a bona fide resident of the State of Florida since day of
~
!1 , 19..~~.., and I reside ~at 1~~!Z- '8 y ~R
.
(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 property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
v
Applying ~ for Homestead
Entering children in school : ~
oAKu RE 4'qRpEO- ;
' :~~IUC~E COUNTY FLI~. r
~ocE F an~sa~s
CtERK Cit~~U~T COURT °
aEr~~ _ v=:~:~ :~0
~ ~ I ~6 PM'~Z ;
w ~
~
; ~7408 '
~
~
1 FURTHER CERTIFY that i wil) comply with all other requirements of a lega) resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. '
? v
. t~~: ~1..TfL~~~S~.~&.fe .e~ ~~1R5 t.9 uL f.e~sc,c ,r,.e,,v
(Name)
' , 7' _
~ . ' - .8 /~SlN t ~,l
~ _ ~ • (Address)
~ ~ ~
- Swor~ to and subscribed before me this ~ day of ~ , 19~~~
RO ER POITRAS
K CIRCUIT URT Notary Public
f3y _ D.C. My Commission expires
~
(To be execufed i+t duplicate and original filed with Clerk Circuit Court, and duplicate with Tax Assessor.)
0 i~. ` !
, _ 8UG1~~ ~Wlt~
- - - - -
- _ _ _
- ~i_ =