HomeMy WebLinkAbout1446 . Declaratio~ ot Domicile and C~tizenship
TO TNE STATE AND COUNTY TAX ASSESSOR, 2~3~1
51. IUCIE COUNTY, FIORIDA:
Ti~is is my declaration of Domicile and Citizensh~p in the State ot florida that I am filing this day in accordance and
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~n co~formity with Chapter 222, Section 222.17, Florida Statutes. `
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1 was forme~ly a legal resident of _ _ _ . ~
~(State) -
(C~ty)
and 1 resiied at _~G GG _ ll_~___~~--____ However 1 have changed my domiCile
(Street and Number) _
to and am and have been a bona fide resident of the State of Florida since _ day of
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14Z~__, and I reside at -
(Street and Number) ~
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FORT PiERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be take~ as my declaration of citizenship, actual iegal 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 j for Homestead ~
Entering children in school :
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C RCUITRAS
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1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. ~
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
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PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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S~to and subscribed before me this _ ~ day of . 19 /°Z
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ROGER POITRAS -
CLERK CIRCUIT COURT Notary Public
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By lj~ D.C. My Commission expires
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(To be executed in duplicate and original filed with Clerk Circuit Court, and dupticate with Tsx Assessor.)
g~~K 206 ~A~~ 1443
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