HomeMy WebLinkAbout0705 ~ 1433~~
Oeclaration ot Domicile a~d Cttize~ship ~
TO TNE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE COUNTY, FIORlDA:
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 forme~ly a legal resident of _ CheSwiCk Penn.
(City) (State)
end 1 resided at Inwood _Vi111~e__ RR #2 _ Nowever 1 have cha ged my domiCi~e
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Florida since Sth day of
November _ 19 65~ and ~ reside ar 3022_Sunrise Blvd.
' (Street and Number) ~
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent fads, such as sale of property or business, or ~elinquishment of employment
at former domitile, removal of family to new domicile, purchase of home, etc.)
Establishing Residence -
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. . _ - ~N AND RECORDED
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~ y'~~,~ ROGER PGj; r;,~s, CLERK
- ~ ST. LUClE COUNTY.
. FLORIDA
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E 1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of ihis State.
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~ t FURTHER CERTiFY that 1 have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, fLORIDA, pe~manently.
~ . G. F. ~unker
~ - ~ (Name)
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F = 'J':~~Y'.:~f~i'~1,.
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£ ~ . ~ ~ - (Address)
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: ";~~?,~rnRo~~~~~suburibed before me this 8th day of M~rch 19 66
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C
y ROGER POITRAS
;
CLERK CIRCUIT COURT Notary Public
' By G~' ' D.C. My Commission expires
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~ (To bs executed in duplicate and ori~inal filsd with Clerk Circuit Court, and duplicat~ with Tax Asssssor.)
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