HomeMy WebLinkAbout1373 DeClaration ot Domicile .~~d Citize~ship
TO THE STATE AND COUNTY TAX ASSESSOR, _I ~ i~,i ~ E) ~
Sl. IUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that t am filing this day in accardance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of _Ove1lStld _P~r~_ _ Kancac .
(Cify) (State)
We s t 96 T e r r ( 7600 ) However 1 have chan y
and I resided at ged m domitile
(St~eet and Number)
to and am and have been a bona fide resident of the State of Florida since _ lst day of
May ~q__ 65and I reside at 1051 Trinidad
(Street and Number) ^
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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 pertine~t facts, such as sale of property or business, or relinquishment of employment
. at former dQmicile, removal of family to new domicile, purchase of home, etc.)
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Establishing residence
AND.RECOROED ~
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~ ,66 M~AR 2 ~ PM ~ .
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_ • • ~ ~ St. CLERK ~ f
- ; R~ST
LUCIc CpUNTY. }
~ ' ~ ~ ~ FLORIDA - j
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I FURTHER CERTIfY that 1 will comply with all other requirements of a legal resident of this State. ~
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I FURTHER CERTIFY ihat I have no intention to return to my former domic,ile, and 1 intend to remain in FORT ~
PIERCE, ~1itw7~Iltl~ylE COUNTY, FLORIDA, permanently_
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• ~ . (Name) ~
- - , - Julian A Bartolini
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~ March 66 ~
Sworn to and subscribed before me this - day of , 19 .
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ROGER POITRAS
~ CIERK CIRCUIT COURT Notary Public
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6y ~'~'4'L D.C. My Commission expi~es
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~ (To b~ exacut~d in duplicate and original ~iled with Cle r ~ urt, and uN with Tax Assessor.) ~
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