HomeMy WebLinkAbout1188 Declaration of Damicite and CE~izenship _
TO THE STATC AND COUNTY TAX ASSESSOR. ;~~131
Sl. IUCIE COUNTY, FLORIDA:
This is my declaration of ~ornicile and Citizenship in the Sta~e of Horida that I am filing this day in accorda~ce and
~n conformity with Chapter 222, Section 222.17, Floric~ Statutes.
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I was formerly a leyal resident oX _ ~uri..' _ _ . _ _ - _
( ) (Sta!e)
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and I resided at _ Howeve~ 1 have changed my domiCile
(Street and Number)
to and am and have been a bona fide resident of the State of FlorEda since ~
- l - - - day of
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- - - 19~~_ , and I reside ~at .s
~lQ~ ---C~a~~~%~ ~ l.c./ C~_ '
(Street and Number) -
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FORT PIERCE, SAINT LUCIE COUNTY, FLORfDA
and ihis statement is to be taken as my declaration of citizenship, actual legal residente 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 do:n:tile, purchase of home, etc.)
Applying ~ for Homestead
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Entering chfldren in school : *
' ~~~li~li~iE COUMTr~I~.
~ ROGER p~~TR~1S ~
CIERK Ct^CU~t COUaT
REC4a0 YER~FIED ~
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I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intentian to return to my ferm~r domiCile, and I int to ~emain in FORT
PIERCE, SAINT Ul61E ~OUNTY, FLORIDA, permanently. ;f ~'y
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,:~~`''~&wom~t'o„ ai~ti;sobsaibed before me this day of , 19~.
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ROGER POITRAS -
CLERK CIRCUIT COURT Notary Public
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E3y _ j~~~ D.C. My C~~r.~ission expires - :
(To be executed in duplicate and original filed with Clerk Cir€ui# Court, and duplicate with Tax Assessor.) '
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