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Declaration of Domicile and Citizenship
o. R.
BOS~
8
24~
TO THE STAlE AND COUNTY TAX ASSE~R.
ST a LUCIE
ST. LUCIE COUNTY, FLA.
COUNTY, FLORIDA:
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 222,17. Florida Statutes.
I was formerly a legal resident oL_____P.AHJ:AD.~~PljIJ..----- 24~_.___
(City)
PA
(SIal.)
and I resided a,-_J~_2_6 _!t~tr..O~~~-~-~!
(Slreet end NutI'Iw)
Howevt;i, I have changed my domic:le
to ar.d am and have been a bona fide reside!"t of the State of Florida since_ -- --
. 15t_h____.___ _ _ _ d~y of
________ F_ebruarY..-. _ _._ ___ ____., 19_6_l., and I reside at _ _ _.2219. N L lr3rs!..?.t_L H~rfI!Qny_J:Leights
~,'.., ond Number;
FT. PIERCE
- -- - -- - - -. -- -- - - - - -- - - - - -- - - - - . ~ -- - - - - - - - - - - -- - - - - - - - -- ,
(City)
_____~'!'!__~~_~!~_____ _____ _ __ d__ County. Florida,
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
or r=iorida.
(INert '-a .ny pertinenl fKb, wen .. wi. of p.-oporty Of bonlnoll, Ol r.llroqu.........." of employment at fotmor domicile,
~rnOYti,.~. fomlly to new domicile. purchaM of homo. etc.)
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I FURTHER CERTIFY that I will register at my local address whe~ !!,e registration books reopen, and oomply with
.11 other requirements of a legal resident of this Stat..
I FURTHER CfRTIFY that t have no intention to return to my former domidle, and I intend to remain in______
__F.Ta-..EIEBCE..------- ------------------ - -
(City;
___ ____ _~_1' L_~lJPl.~___________ _ County, Florida.
per!'Mnently.
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