HomeMy WebLinkAbout1249 Deciaration ot Domicile a~ti Citize~ship ~
143'~ ! ?S
TO THE STATE AND COUNTY TAX ASSESSOR,
Si. IUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Flo~ida that 1 am filing this day in actordance and
im m~formity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of ___pOint._ Plea~ant_ _ NPw iPrcP~_
(Ciry) (State)
and 1 resided at _ 623_FOrmar~_~_v~_~~____. _ However 1 have changed my domitile
(Street and Number)
to and am and have been a ~ona fide resident of the State of Florida since 30 day of
~ugust 19_65, and I ~eside at 1~~~lestia Court
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
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 facts, such as sale of property or busi~ess, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establishing residence
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RECOROED
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ST. ~ FLORIDA N7Y. ~
I FURTHER CERTIFY that I will comply with all other requirements of a lega) resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former domicile, and I intend main in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_
+t . , r ~^j rY ~..C/ ~ ~
a- J _
~ ~ " ~ (Name)
~u . %
~ ; ~ William A. Taylor
_ ' •'y = • ` Y • '1, '
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j~ - Dauphine H. aylro
4~:
` 18th March 66
.;;;3yr~~ and subscribed before me this day of , 19 .
ROGER PORRAS
K CIRCUIT COU~T Notary Public
1~
8y IO D.C. My Commission expires
(To bs executed in c~upliute and original filed with Clerk Grcuif Court, and duplicat~ with Tax Asses~wr.)
gooK 14~. 47
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