HomeMy WebLinkAbout1392 Decla~atio~ ot Domicile and Citizenship ~
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TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUClE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizensh~p in the State of Florida that 1 am filing this day in accordanee
~n conformity with Chapter 222, Section 222.17, Florida Statutes. ~
I was formerly a legal res~dent of ~uo~~ta_ _ Geor~ia
~~;ty~ (State)
and 1 resided at _ _ 1445 k~~,aewOOd DZiVe _ . However I have changed my domiGile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 1St day of
.____,j~11y_ _ , 19
65__, and I reside at 1705 _GE'oi ia Ave. ~
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida.
(Insert here any pertinent facts, such as sale of properry or business, or relinquishment of employment
at former-domicile, removal of family to new domicile, purchase of home, etc.)
F,}i~~7fg~X~B~~~iXB~I Establishing residence
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ft~E~ ~''NG RE~~R~pOK
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I FURTHER CERTIFY that I will comply with al) other requirements of a legal resident of this State.
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I FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT
PIERCE, SAl(t~T;~l~.j~~E COUNTY, FLORIDA, permanently_
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7 . ~ : ; _ (Name~ ,
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~ _t_. _ ~''illiam F. arter :
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~ ,,,~.:~:~t~t' 22nd
~ Sworn to and subscribed before me this day of ~rCb ~~q 66
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~ ROGER POITRAS -
~ K CIRCUIT URT Notary Public
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~ By D.C. My Commission expires
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~ (To be executed in dupliute and originsl filed with Clerlc Circuit Court, and duplicat~ with Tax Ass~ssor.)
~ BooK 141 189
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