HomeMy WebLinkAbout0331 . Q~:ct~~r~iti~,n ot t3ori~icit;: :tttti Citi~_c~nslti~
TO THE STAtE AhD COUNTY ~AX ASSGSSOR, ~~~5
Sl. lUC1E COUNTY, FIORIDA: •
lhis is my decla?ation of Domicile and Citizenship in the State of Florida that I am (iling Ihis day in accordance and
in conformity with Chapter 22?, Section ?22.i7, florida Statutes.
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1 was formerly a legal resident of ~~~t~U~~~-~
(Ciy) (State)
and 1 ~esided at (U' `L.r.~.~p . However 1 have changed my domiG~e
~ (Street and Number) ~
to and am and have been a bona fide ~esident of the State of Florida since ':i~llc~~~ ~ day of
19.~, and I ~eside ~at ' ~ / ~ ~ '
(Street and Number)
FORT PIERCF, SAINT LUCIE COUNTY, FLORIDA
and thit statement is to be taken as my declaration of citizenship, actual legal residence and domicite in the State of Florida.
(Insert he~e any pertinent fads. such as sale of properiy or business, or relinquishment of employme~t
af fomner domicile, removal of family to new domicile, purchase of home, etc.) ~
25U098
Applying, for Homestead ' fi~o ~p ~tE '
iT. ttIC1E 60U~~ -
1t4CEn fpiTRA~
- Entering children in schooi : ~ECaao vEF~
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1 FURTHER CERTIFY that I will comply with a!! other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiCile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
,
v.~
. ~ (Name)
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, ~ ~ ./~o-~ 3~0
-f - . . -.'t , (Addre~-
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,
Swom to ~and ~SUbscribed before me this day of , 19~~
T ~ . _
ROGER POITRAS
LERK GRCUIT COURT Notary Publit
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QY D.C. My Commission expires
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' (To be oxocuted in duplicata and oriUinal filcd wilh Clcrk Crcuit Court, and duplicato wilh Tax Assossor.)
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