HomeMy WebLinkAbout2346 . Oeciaration ot Domicile and Citizenship
TO THE STATE AND C()UNTY TAX 115SESSOR. 23~3891
51. IUCIE COUNTY, FLORIDA:
This is my declaration of Oomicile and Citizenship in the Sta~e of Florida that I am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of -~r.='-"~~t1/_ -
(Ci~y) (State)
and 1 resided at ~ ~ However 1 have changed my domi~ile
--s~L-'-----
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ~_C - day of
- - - 19---, and I reside ~at _sl_ ~/~UCc ~ ~OV~-t
(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 Ftorida.
(Inserf here any pertineni 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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1 L~/ T~Ti c~ O N~ S Mc~~ ~aR~
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~ I 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 domiCile, and I intend fo remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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G V (Name)
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N ~ r t ~ . ; (Address)
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~ ~~S rntt~'~ subscribed before me this da of <<t~ 19 ~i
J~B c~ y .
•
~ ROGER POITRAS
~ CLERK CIRCUIT COURT Notary Public
~
~ E3y D.C. My Commission expires
~
(To be executed i~ duplicate snd original filed with Clerk Circuit Court, and duplicate with Tax Assessor.)
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, goo~206 PAGE2342
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