HomeMy WebLinkAbout2177 Declar~tian ot Domicile and~ CitizeRSitip :
24~9p1 ;
TO TNE STATE AND COUNTY TAX AS,SESSOR, ;
51. IUUE COUNTY, FlORI~A; _ 3
;
1
This is my declaration of Domicile and Citizenship in 1he State of Florida that I am filing this day in accordance a~d
in conformity wilh Chapter 222, Section 222.17, Florida Statutes. i
!
t was forme~ly a legal resident of _ ' ~
;
~ (City) (Stafe)
and 1 resided at _ However 1 have changed my domiCi~e
(Street and Numbe~) -
1o and am and have been a bona fide ~esident of the State of Florida since - ~ day of
~ ~ ~ ~
, 19 yand I reside ~at
~ (Street and Number)
FOR? PIERCE, SAINT LUCIE COUNTY, FLORIOA
and this statement is to be taken ~as my declaration 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 relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Applying, for Homestead
- Entering children in school : r~ `~~~.u ~-~-t-~' .
24U901 -
FttE0 Aq0 RECORpED > '
ST. ~UCIE COUMTY fLA.
OCER P~tTRAS
CIERK CIRCW? COURt
RECORO vERIFIED.,.,.,~~.. ~
~f 30 9 5z A!t'7Z G~
. ~e~
1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
1 FURTHER CERTlFY that ! have no intention to return to my mer o icjle, ntend to rem 'n in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanent(y. ~
~
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.
~ ' -
~ j`~~ Richard B Po larb
~~~o . r. = .
: _ 3~- 3 8~ e-t'
' .•'~J, ''f T: l
: a , ' c : : LL;~ ,
' . ~ 1 f' (Address) '
tA`. ~ .~~s~~.,~~.~` . ~
~ ~~yqtn.•tt!'~~~b'6~scribed before me this °30 ~ day of ~~''f'> , s
~ E ~ , 19,~._Z_' :
..~~~N - ~
_ . :
RO. ER POITRAS ~
jCLF~K CIRCUIT COU4T Notary Public
g cr.c_~l-e- ~c~li-Gl~c~ • `
Y D.C. My Commission expires
(To be oxocuted in duplicate and oriqinal filed with Clerk Circuit Courf, and duplicate wilh Tax Assossor.)
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