HomeMy WebLinkAbout1585 . Q~:cl~zr~.tic~i~ vt C.~ornicit~ ~-~ci:i Citir.cs~sjii~
TU TNE STAIE AND COUNTY T/1X ~1SSf:5SOR, 2~999
;l. LUCIE COUNTY, FtORIDA~
This is my declaralion of Domicile a~d Citizenship in the State of Florida that I am filing this day in auordance and ~
in co~formity with Chapter 222, Section 222.17, Florida Statutes.
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I was formerly a legal resident of -~'r~~""
(C;ty) ~ ate)
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and I resided at ~C~- . However I have changed my domic~te
~ (St~eet and Number)
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to and am and have been a bo~a fide resident of the State of Florida since ~Y ~
_ ~ 19 ~ and I ~eside ~at • ~ ~ ~ , a'''`~
~ (Street snd 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 Hotida.
(Insert here any pertinent fads,. such as sale of property or business, or relinquishment of emptoyment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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Applying~ for Homestead ~ -
F~~eo •Mo aECORpEo
~ / iT.~UCIE COUMTY fLA-
- Entering children in school AOCER PO~T~t~s
c~ERK c~~cu~T cou~
. RECOaO vE~~f~EO_.,.~-
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I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of fhis State.
( FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAI~1T LUCIE COUNTY, FLORIDA, permanently.
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~Wamn~tb'anii~subscribed before me this ~ day of , 19
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~ ER POITRAS
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R~/ Nota~y Public
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ey _ D.C. - My Commission expires
(To be oxocutod an duplicato and ~nal filed wifh Clerk Grcuit Court, snd duplicais witb Tax Assessor.)
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