HomeMy WebLinkAbout1375
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11397t('
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TO THf; STATE ..ND COUNTY TAX ASSESSOR,
"
ST. LuCIE COUNTY, FLORIDA:
This is my declaration of Domicile and CiUaenlhlp In the State of Florida that I 1m fj:i~ thb 4'1 in aecoroane.
and in conformity with Chapter 222. Section 222.17, Florida Statutes.
I was (ormerly a legal resident of
Brook~
(City)
....
lev York
State
an I I resided at 13905 .lTeDUe .n.
(Street and Num~r)
However. I have changed m1 cJomlcile
....
t,) Hn.1 11m and have be~n 11 bona fide resident !Yt the State of Florida since
1,t.h
day of
,
1917 ... Slat St. ,HanaolV' Heights,
Fort Pieroe, Florida,.
. and I reside at
March,
1963
(Steet and Number)
FORT PIERCE, SAI~T LUCIE COUNTY, FLORIDA,
IInd thi~ statl'ment is to be taken as my declaration of citiHnship, actual legal residence and domicile in the State 01 Florida,
(Insert here any pertinent facts. such 18 sale of property or bwineaa. or relinquishment of emplopnent
at former dOlniclle. removal of family to new domicie, purchase of home, etc.)
Beoause of . re1inquishMnt of e~101'_nt in Mev York
State by IItV retireEnt fro. IV old job.
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113977
IN FltfIh~r BECORDED
RiCOnfOOOK
1963 HaR 14 PH ,: 4'
. )
ROGER POITRAS CLERK ~y
ST. LUCIE COUNTY, F'lDRiDA ;Jp~'r
I FURTHER CERTIFY that I will re~ster at m1 loeal addreu when the ~b'aUO:1 boob reopen, and coD1'ply
.,;,;th all other requirements of a lega: resident of this State,
I FURTHER CERTIFY that ! have no intention to return ~ &01)" former domlcUe, and I intend to rcmalD in
FORT PIERCE, SAINT LUClE COUNTY. FLORIDA,
~nun'.h ~~
11917 - 51at st.,1f&n!oD;T Heights
Fort Pierce, llorida
(Address)
Sworn to and 8ub/lcribed before me this 13th
ROGER POITRAS
CLERK CIRCUIT COURt
3y
D,C.
.'
.. ,
(To be exet:utcd In dupllcate and orlriul rued 1l'Itll CJftt ClmIit CotIrt, aM dllpliea.te with Tn AllIIII_)
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