HomeMy WebLinkAbout1903 D~claration ot Domicile and Citizenstiip 2616~1
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that 1 am filing this day in accordance anc!
in con~o~mity with Chapter 222, Scction 222.17, Florida Statutes.
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I was formerly a legal resident of
~C~~y~ (State)
and t resided at a . Howeve~ 1 have changed my domiCile ~
• (Street and Number) ~ y
to and am and have been a bona fide resident of the State of florida since~ day of
~ C~~~"`~~~ , 19~, and I reside ~at 3 ~'Z',
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
and this statement is to be taken as my decla~ation of citizenship, actual legal reside~ce and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of propery or business, or relinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.) ~ ~
Applying~ for Homestead - ~
- Entering children in school :
. 261601.
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LIIOCIE COUNTY FLA. -
ROGER POttiUi
CIERK CIACUIT COURt
. RECORO YERIf1E0o~
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1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently:
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Sworn'to`and subscribed before me this ~ day of ~ , 19~•
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ROGER POlTRAS
RK CIRCUIT COURY Notary Public
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[3y D.C. My Commission cxpires
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~To be oxecuted in duplicato and ori~inal filed with Clerk Circuit Cour1, and duF~licato wi11~ 7ax Assessor.)
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