HomeMy WebLinkAbout0339 Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSCSS~R,
Si . LUCIE COUNTY, FLORIDA: `51S
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Tliis is iny declaration of Domicile and Citizensliip in the State of Florida that 1 am filing this day in accordance and
~n conformily with Chapte~ 222, Section 2?2.17, Florida Statutes. ~
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I was formerly a legal resident of ~l,~011~!~T-P~ ".t~~~ - '
(City) (State)
and I resided at _~~j.__QQ~I~._-_-_-- However I have changed my domiCile ;
(Street and Number)
n h v en a bona fide resident of the State of Florida since _~E _T_E/ll~E ~ ~ day of ~
to and am a d a e be ~
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19~.e~, and I reside at t~TiYEi~'/S' t D, p.~c .c
. (Sireet and Number)
fORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my decla~ation 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 relinquishme~t of emp~oyment
at former domicile, removal of family to new domicile, purchase of home, etc.) ~
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Applyingj for Homestead
Entering children in school ;
-C/vya~viE /~l~Cf//~EL ~/!!ES
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I FURTHER CERTIFY that 1 wifl comply with all other requirements of a legal resident of this State. ~
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I FURTHER CERTIFY fhat I have no intention to return to my former domiCile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~•S~Ko and subscribed before me'this day of ~ , 19~ ~
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ROGER POITRAS
CLERK CIRCUIT COURT Notary Public s
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By ` D.C. My Commission expires `
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(To be executed in duplicate and original filed with ~lerk Circuit Court, and dupliwte with Tax Asseswr.) ~
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d0ox FACE
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