HomeMy WebLinkAbout1631 Declaration ot Domicile and Citizenship ~
TO THE STATE AND COUNTY TAX ASSESSOR, l~~ 1 E~
51. LUCIE COUNTY, FLORIDA:
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.
IAU ISV I LLE KF.NTtiCKY
I was fo~merly a legal resident of . - _ _ - - -
(~;ty~ (State)
524 Barrett
and 1 resided at _ _ _ . . _ _ _ _ _ . However I have changed my domiCile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since . 24 day of
_ ~~~g 2801 Citrus Avenue
- I?~rCh-- - _ , i9__66, and I reside at _
(Street and Number)
FORT PIERCE, SAINT IUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual tegal residence and domicile in the State of Florida.
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(Insert here any pertinent facts, such as sale of properry or business, or relinquishment o{.e'irc~~by?1~t
.
at former domicile, removal of family to new domicile, purchase of home, etc.) ' t.,;. _~s,~ti
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Entering children Jerry Wayne Diehl in 8th Grade
Donald Lee Diehl i~n 7ti~ Ggade
David Eugene Diehl in Sth Grade
FILEO ANG RECO DED
~40K
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s MQR 2 8 AM I I. 4 9
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ROGc rt : n~,:~. ~LERK -
ST. LUCIc COUNTY.
- FLOR1~,~
1 FURTHER CERTIFY that I will comply with all other requirements of a lega) resident o this State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently.
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- ( a e)
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-t~ - ~ ~ Leonard Jordan
~ ~ G~~~ ~ ~ (Address)
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'~,.•r~~"' 28 INarch
S~iiorfi ~o and subscribed before me this day of - , 19~.4
ROGER POITRAS
CLERK CIR IT COURT Notary Public
gy D.C_ My Commission expires
(To bs executed in duplicate and original ~iled with Clerk G~cuit Courf, and dupliwts with Tax Assessor.)
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