HomeMy WebLinkAbout2245 . OeClaration ot Domicile and Citizensl~ip
TO THE STATE AND COUNTY TAX ASSESSOR,
51. tUC1E COUNTY, FLORIDA: ~ 26182~
This is my detiaration of Oomicile and Citizenship iri the Sta~e of Hwida that 1 am filing this day i~ accorda~te and
in conformity with Chapter 222, Settion 22?.17, Florida Statutes.
I was fomnerly a legal ~esident of •~s e~ I'~ v/,~
(5tate)
and 1 resided at 1.~Q~ o ul ~r . c~ ~ L~ ~C; However 1 have changed my domicile
• ~S et and ~
to and am and have been a bona fide res'idem of the Sta~ of Florida sinoe ~k S~ l day o~
`
~ 19Z, and 1 ~eside at ~ -2 , r~ t . P / ~ -
lStreet a~d Number)
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FORT PIERCE, SAINT LUCIE COUNTIf, RORIDA ~
and this stateme~t is to be taken as my declaratwn of oitiza~ship, ad~al kgal residenoe and cbmicile in the State of Fbtida.
(Insert here any pertinent facts, wch as sale o# property or business, or relinquishrnent of employment
at former domicile, ~emoval of family to new domi6k, purd~ase of home, eic)
- Applying, for Homestead -
- Entering children in school : _
~ ~u~t u-e ~ ~ ~ . - ~o n~re a~~~
ST_ ItIGE C~ L -
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~ CIERIC G ~r~~~ 1~
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2s182~
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1 FURTHER CERTIFY that 1 will oomply with all other teq~i~rements of s le~l resident of this State.
I FURTNER CERTIFY that I have no intention to return to mp former dom+cile, and 1 interxl to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanentty. "
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~-1'e: -'1 ! ;~,fiS~ _ y
~;s. rr t`~: s, ~~~s}cribed before me this --2 d day of . 19.L.~~
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~~E1~ER~'~~lTRAS
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~ ' CLERK CIRCUIT ~OURT - ' Natary Public - ~
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t3y ~ O.C. My ~wtxnission expites
~
- (To be oxecuted in duplicate and originaf filed witb qerlc Grcwt Court, and dupticate with Tax Assessw.) s
b001~~7 PA6E~ ~
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