HomeMy WebLinkAbout2071 • ~~:C~~~1Ii i~C111 Ut ~:U[i7t~ i~:: i:li~1 C.I~f::~:i1:;1'el~?
10 Ti~C STAIE AND CUUNTY TAX nSSI:S.SOk,
51. LUCIE COUNTY, FLORIDA: ~r~48
This is my dcclara~ion of ~omicile a~d Citizc~ship in the Sta~e of Florida that I am filing this day in atcordance a~d
in conrormity with Chapter 222, Section 222.17, Flo~ida Statules. . ~
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I was formerly a legal resident of.. 'fh~
. ~~ity~ (State)
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end 1 resided at ~ y~~ ~ . However 1 have changed my domic.ile
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~o end am and have been a bona fide resident of the State of Florida sinte day of
~ • , 19~,~, and I reside ~at , ~ 6 , F ' ' ~2 c~ ~
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fORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~ ~
and ihis statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
pnsert here any pertinent facts,. such as sale of property or business, o~ relinquishment of employment
et forme~ ~domicile, removal of family to new domicile, purchase of home, etc.) ~
Applying~ for Homestead . ~ -
- Entering children in school : . ~ ~
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1 FURTHER CERTIFY that 1 will compty with all other ~equirements of a legal resident of this 5tate.
1 fURTHER CERTIFY that I have no intention to ~eturn to my former domiGle, and I intend fo remain in FORT
PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently. '
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• (Name) C I~~ ie F C o~E
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(Address)
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~ Sworn. tQ, and subscribed before me this 3 day of , 19 73 .
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R06ER PDITR~
_ ~:~LERf~ CIRCUIY. R Notary Public
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~ E3y , D.C. My Commission expires
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(To ' iNttKUf~it'~in duplica~o a~J t-•~nal tilod wilh Clerk Circuit Court, and duplicato with Tax Assossor.)
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