HomeMy WebLinkAbout2211 . D~cf~~r<<ti~n ot Rutr~icile ~~cia Citizcnsl~ip
251460
TO THE STAiC nND COUNtY Tnx nSSCS,soR,
51. lUC1E COUNIY, FIORIDA:
This is my declaralion of Domicilrs a~d Citizenship in the State of Florida that I am iiling this day in accordance and
~n conformily with Chapter 222, Section 222.17, Florida Statutes.
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I was formerly, a Icgal resident of _
~C~ty~ (State)
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and I resided at ~'S~D ~~~'e'~~ However I have changed my domitile
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ta and am and have been a bona fide resident of the State of Florida since day of
~ , 19~, and I reside ~at i~~x ~"76 ^ .
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORlDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicite in the State of Flo~ida.
(Insert here any pertinent facts,. such as sale of properry or business, or relinquishment of employment
at former domicife, ~emoval of family to new domicile, purchase of home, etc.) ~
~ - 251460
Applying ~ for Homestead f 0 AMp ~i
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- Entering children in school CLEitK CIRCUIT COfIAT
RECORD VERtFIEO.~„~~
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1 FURTHER CERTIFY that I will oomply with all other ~equirements of a(ega) resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former omitile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently. ~
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~~'Swom~~li and~u~3cribed before me this day of . 19~
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ROGER POITRAS
RK CIRCUIT COURT Notary Pubtic
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E3y ~ ~ D.C. My Commission cxpires
(To be oxocuted an duplicate and c'nal filod with Clerk Circuit Court, and duplicats with T~x Assessor.)
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