HomeMy WebLinkAbout0551 Declaration ot Domicile and Citizenship ~
TO THE STATE AND COUNTY TAX ASSESSOR. 1433Q6
51. lUC1E COUNTY, FLORIDA:
This is my deciaration of ~omicile and Citizenship in the State of Fiorida that 1 am fili~g this day in accordance and
in conformity with Chapter 222, Section 2~Z.17, Florida Statutes.
1 was formerly a legal resident of __~enSeD Beach_ Fl~~rida _
(City) (State)
St 8i ROUt e Hovvever 1 have changed my domiCile
end I resided at - - - - - -
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ~_20_.____ day of
_ O~~Q.~t , 19
65, and I reside at 502 Tumbling Kling Road
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual lega) residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of properiy or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Estiblishing residence
1.,~.qfV~rREL~ RD E D
. 'FI OaT~S•1_v~ K~v 900K
C~.'%;.
G
i ~ , ~ ~
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~ . _-1,i , '~6 f~~1!.~t 4 PM 2 : 35
' _ Y ~ 1433~6
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3 . ~ ROGE s; i-~; i;~~:~. CI.~RK
~ , '~1`<<~ ST. LUCIE COUNTY.
~ . • ~;,`3•;t,,:~ FLORIDA
,
..~,iti;:1
&
~ I RIRTHER CERTIFY that I will comply with all other requirementa of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
'f; ~
ti~ `a-ti~
~ ; ~
. . . (Na e)
~ Bdward Jones
~ (Address)
~ - - . !
~ , ;
"Sworri to and suburibed before me this 4 day of 1Karch ,~q 66 j
~
ROGER POITRAS
~IERK CIRCU COURT Notary Public
By ' D.C. My Commission expires
~ (To b~ ex~cuted ~n dupliwt~ snd oripinal Fled wlth Cl~rk Grcuit Court, and dupliuh with Tax Ass~ssor.)
~
~ aooK 139 . 548
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