HomeMy WebLinkAbout1573 peelaration ot Domicile and Citizenship ~
T~ TH~ STATE AND COUNTY TAX ASSESSOR, s~",'.
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Sl. WCIE 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, Sectian 222.17, Floride Statutes.
I was formerly a tegal resident of ~l~YLII~L'I . C3.~ _ _ _ _ _ -~~_.~.1~- .
(C i ry) (State)
P.O.Box 493
and I resided at _ _ _ _ _ _ _ _ _ _ . _ _ _ However I have changed my dami~ile
(Street and Number)
to and am and have been a bona fide resident of th~ State of Florida since 26th _ _ day of
Sugnst 202 South 24th
- - - - _ 19--~~ and I reside at - _
_ _ -
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNl'Y, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Harida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicila, remo•„al nf family to new domicife, purchase of home, etc.)
Bnt~ring children io school
One in Bleaen#arq and One in Jr. ~igh
p AND PcECePt~E~
. , . FILE ~OOK
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• 1 RQ~'_I~ ~ ~ ~~UNTY~
~ SY. LUCIc. A
, . F~ORID
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I FURTHER CERTIFY that I vvill comply with all other requirements of a legal resident af this State.
I FURl'HER CERTIFY• tt?at I have no intention to return to my forrner domiCile, and I intend to remain in FORT
PIERCE, SAINT LI;CIE COUNTY, FLORIDA, permanently.
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. r1RS ~~chard L. parl~er
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~vlit~mrto and subscribed before me this ____~#h____ day of -_~ti.g.uS~----- , 19~__.
ROCER POITRAS -
RK CiRCUIT URT Nota~y Public
c~~.c..~,' c~ ~O
g D.C. My Cnmmission expires
(To b~ execut~d in duplicate s~d original ~iled with Clerk Circuit Court, and duplicste with Yax As~wssor.)
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