HomeMy WebLinkAbout0105 _
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Decia,ra46on of ~o~i~i~e a~d ~i4iz~n~iti~ . ;
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TO THE STATE AND COUNTY TAX ASSESSOR, _i ~t3~
Sl. IUCIE COUN1'Y, FIORiDA:
This is my detlaration of Dumicile and Citizenship in the State of Florida that I am filing this day in accordance and
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in conformity wifh Chapter 222, Section 222.17, Florida Sfiatutes. f
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I was forme~ly a legal resident of ~8 rt
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(City) - (State)
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I.ake Road Neupoi-~
and I resided at However 1 have changed my domi~il~
(Street ar~d Numher)
to and am and have been a bona f+de resident of the State of Florida since _ day of ~
December 65 2l~O1 Oleandar Aoe,
19---_, and I reside ai
(Street and Number)
FORT PIERCE, SAINt LU~IE COUNtY, FLORIDA .
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and this statement is to be taken as my declaration of ciiizensnip, actual legal residence and ~omiciie in fhe State of Florida.
(Insert here any pertinent fa~ts, such as sale of property or bus+ness, or relinquishment of employment ~ ~
at former domicile, removal of family to new ciomicile, purchase of home, etc.? t
xe;r Da~i.cil~ "
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~~~EO ~,NO R~co~nEe~ ~
IN_._. . •~~.'~?£~-9~-~OOK ~
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~'65 QEC 3 0 PM 3: I S
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- - - ~ - ~ - ROGc,-; ;~:~~~C>~~ CLEc-~K
, ~ ~ : ~ST. LUC1E COU~~lTY, ~
~ . • _ ~ FLORIDA
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I FURTNER CERTIFY that I H~ill comply with al( other requirements of a legal resident of this State. ~
I FURTHER CERTIFY that I have no intention to return to my former domi~ile, and I intend to remain in F~RT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permaner~tly. ~
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~ . . John J. t,Yako~ski
. J,." . (Name) -
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Sv;ro~n to and subscribed before me fihis 3~ day of ~ ~Q~ber ~ 19 ~
ROGER POITRAS
CLEitK ClRCUIT COURT Notary Pubiic
BY - D.C. My Commission expires ~
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(To be executed in duplicate and original filed with Clerk Circuit Court, and dupliwte with 7ax Assessor.) ~
Boox ~35 ~0~ -