HomeMy WebLinkAbout0828ST. LUCIE COUNTY, FIA.
Declarotion of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
3t . Lua ie COUNTY. FIARIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in
accordance, and in conformity with Chapter 222. Section 222.1?, Florida Statutes.
I was formerly a legal resident of_______Y~hatllcsn_____________________-_________-- ----____-, -----_--Aiiannnsia___-____--
(cit,) (state)
and I resided at 1002 N. -2.3_ .3tre.~iL .- _ However, I have chanA^rd my domicile
- (street sad Number)
to and am and have been a bona fide resident of the State of Florida since 9 -_. day of
- ----Tat1u9T~_____--________________________ 19.41_-, and I reside at-________________~-QQ)!I[1sit~.ey_~ad•-- Whit~Cit,~-----------
(Street and Number)
Fort Pierce 3t. Lucie ______ _____ ____ ___ _~114ty, Florida,
------------------------------------ --------
- caty)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in
the State of Florida. r
(Insert I,e~ce at,y vretiriet,t facts. such as sale of royertyy or business. or rsiinquishment of employmeat at
forme: domicile, removal of family to new domicile. purchase os home. ete.)
9161 ~ ~=,~.~~~ ,
• r
:i1 UC E C4UN~Y.flOh1~A~
5 -.
I FURTHER CERTIFY that I will register at my focal address when the registration hooka reopen,
and} ~.nrr~niv with a)) ~i-hPr rpnai,~•me~nty n4 n iao~ai rwainpnt of i:hix ~iisie.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain
~__ lbyt_-Pierce ______~ _-__ _~_
- -----'-t,,,~4~4---------------------_--County, Florida,
permanently. (Cli7)
- ---- -------------
(Name)
_lI9IIi! C . H9l?4Ta~Il------------------------------
(Addreu)
Sworn to and subscribed boiore me this--1S~_____day of
J-a-~K~- ------- ---------. A. D. 19..6]...
_ ._ rP itrea~Chrk ofCirauitConrt , .....
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l2~itl:l~Y /~ ,
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' J, ,~ .'`fit
. ,.
(1b be eltecnted in d~lkab and otigiwl sled with Clesic Ci:roit Court,
~daphcab will, Tart AtwMOe)
Re..w Itsssb Cs.. Pleat Cltr. iris.