HomeMy WebLinkAbout0126 Declarltion ot Domicile and Citizensi~ip
TO THE STATE AND COUNTY TAX /1SSESSUR, 2394~3
51. IUCIE COUNTY, FLORIDA:
This is my declaration of Dornicile and Citizenship in the State of Florida tiia! I am filing this day in accorda~ce and
~n conformity with Chaptcr 222, Section 222.17, Florida Statutes. •
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I was formerly a legal resident of ~Q_/~___~_____ i C/l i
(City) (Stat~
and 1 ~esided at ~~3 -r ,~j/! i C~___1~~
. 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
~7 / ~.~,~C ~
. 19 and 1 reside at ~ O ~ _.~sE'~ a~' ~ .~l . _
~ (Sfreet and Number)
~
FORT PIERCE, SAINT LUCIE COUNtY, FLOE~IDA
and this statement is to be taken as my declaration of citi2enship, actuat legal residence and domicile in the State of Florida. :
(lnsPrt herP ~ny perlinent facis, such as sale of property or business, or relinquishment of employment }
at former domicite, removal of famity to new domicile, purchase ot home, etc.)
Applying, for Homestead ~
- Entering children in school ;
,~~i/~/~ ( ~9 e ~t ~ ~ .
F ~ ~
~ .~~4 ~Q~Gfi EP
~C~'?F P ~ ~,q /~cue /3
~ ' fILEO ~ItrO RECORpEO
. tT_ lbC1E COUNTr FtA.
ROCf R PO~~~S
CIERK C:r:~U~T C !
~ RECORD vEF?ry
~t 6 4 t~ PM ~rz
~ ~ 2394~3 -
1 FUR7H~R CERTIFY that I will comply with all other requirements of a legal resident of fhis State.
I FURTHER CERTIFY that I i~ave no intentio~ to return to my former domiGte, and I intend to remain in FORT
I PIERCE, SA~~j IUCIE COUNTY, FIORIDA, permanently.
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:,~liC••••.....•''~~C~.`~ (Address) -
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Sworn to and subscribed before me this day of ~ ~q 7,Z_
~ '~'L- «'~~zl«
ROGER POtTRQS ~
CLERK CIRCUIT COURT Notary Public
. .
QY - ~ ~jzc1-~ D.C. My Commission expires
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~ (To bo oxucutcd in dup~icate and ori~ena! filed wilh Clcrk Circuit Court, and duplicato" with Tax Assoswr.)
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I ~n~~R~~~ VACE
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