HomeMy WebLinkAbout0060 . aeclar~~tion ot t~orntcil~ ~~tld Citizetlahip _ ;
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1 U TNE STA1 E ANL~ CQUNTY TAX ASSLSSUR,
51. lUC1E COUNTY, FIORIDA:
This is my decla~ation of Domicile and Citizensl~ip in tho State of Florida that 1 am filing this day in acco~da~ce ancl +
in conio~mity with Chapte~ 222, Section 222.17, Florida Statutes. ~ .
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I was forme~ly a legal resident of , ~~.Z
(C;y) (State)
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and ! residEd at _.~Q~_ c~~ ~/?'t~'1J~~'/~'u~ However I have changed my dornitile
• (Street and Number) ~
~o and am and have bee~ a bona fide resident of the State of Florida since ~ day of
~ • , 19~, and I reside ~at . 7 7 ~ ~ ~ - /1.l~V~l`~CJ.CI~j.
(Sireet and Number)
FORT PIERCE, SAlNT LUCiE COUNTY, fLORIDA - ~
and this statement is to be taken as my declaration of citizenship, actual legal residence a~d domicile in the State of Fiorida.
(Insert he~e any pertinent facts,. such as sale of prope~ty or business, or relinquishment of employment
at fomner dorriicile, removal of family to new domicile, purchase of home, etc.) ~
, 2499~
Applying, for Homestead ~ .
i LEO AN~ f:ECOR f0
t~. LUCIC GOUMTY ~LA.
- Entering children in school RACE~• r~~TRAS ~
C~ERK Cc~it,~11 COURT
- aFCapt? v. ~
. - . ~ M~ut 8 Zs A!!'73 -
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I FURTHER CERTIFY that I will comply with _alt other requirements of a lega) resident of this Staie.
1 FURTHER CERTIFY that I have no intention to return to my former domiule, and I intend to remain in FORT
~ PfERCE, SAINT LUCIE COUNTY, fLORIDA, permanently. "
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~~'i y; i Cp~••., ~ " (Name) ~
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•!~,$yi~p'ri~ And subscribed before me this day of , 19
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ROGER POITRAS ~
EItK CIRCUI~ COURT Notary Public
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; gY ~G~~ O.C. My Gommission cxpires
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i (To be oxocuted in duplicato and o~iginal (ilod wilh Ctcrk Circuit Court, and duplicato with Tax Assossor.)
~ ~ 800K~~,Z PACf • -
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