HomeMy WebLinkAbout2021 • L'~~:ci~ir«tian of Dornicile ~~c~ci Ci:izc:nst~ip ,
TO TNE STATE AN~ COUNIY TAX ASSESSOR,
251344
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Sl . llK1E COUNTY. FlOR10A~ •
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ihis is my declaralion of Oomicite and Citi:enship in the State of Flo~ida that t am tili~g this day ~in acco~dance and
in confa~mity with Chapter ?22, Sectio~ 22?.17, Florida Statutes.
1 was forr~e~ly a iegal resident of . ~
(Ghr) (State)
and t ~esided at ~oG• ~ ~.~-~_y Howevcr 1 have cha m domiGile
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' (Street and Number) •
eo and am and have been a bona fide res~dent ot the State of florida since ~ day of
, 19~ . and 1 ~eside at . ~
- ~ (Streef and Number~
fORT P~ERCE,.SAINT WCIE COUNTY, RORIDA
and this statement is to be taken as my declaratwn of citizenship, actual legal residence a~l domicile in the State of Florida.
Q~rt hefe any pertinent facts, sud~ as sale of property or busineu, or relinquishment of employment
at fonner domicite, removal of family b new domicile, purchase of home, etc.) ' ~
Applying, for Homestead .
- Entering children in school ~ ~Y~ J~
- 251344 a / J
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1 FURTHER CERTIFY that ! will comply with aU other requirements of a legal resident of this State.
1 FURTHER CfRTIFY that 1 have no intention fo return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT L11C~E COUNTY, FLORIDA, permanently. -
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S~r~rn"`1o-~ao~ s~bscr~ed before me this ~ day of ~ qL-3
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ROGfR PQITRAS
CIERK G3tGUR COURT Nota~y Public
e .~.-t~~L ?a
a-c.e!-~~i ' ~
y ~.C. My Commission expires
,
(Ti be e:ecarled iw derplic:~e and piginal f;led Rb qe~fc C'ircuit Coutt, and duplicat~ with Tax Assessor.)
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