HomeMy WebLinkAbout1677 Declaratio~ ot Domicile and Citizenship ,
TO THE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE COUNTY, FlORIOA: i~~3 J'~ ~
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day i~ accordante a~d
~n conformity with Chapter 222, Section 222.17, F(orida Statutes. ~
~
I was formerly a legal ~es~de~t of . _ __Midford Farms New Jersey
(City) (State)
and I ~esided at _ Rt aZBaZZ_ _206 . However 1 have changed my domicile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since lSt ____~i day of
December ~9 __~S and I reside at Rt 3 Box 533-1H Of fOrange Ave Ext
(Street and Number) ~
FORT PIERCE, SAINT LUCIE COUNTY, FLORtDA
and this staiement is to be taken as my declaration of citizenship, actual lega! residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.)
Establishieg residence
~
,
~ ~ 7:-~.. RECOR~~~
~ FI~ED ~`N~ gpOK
_ '.`i: 'N • •
~ ~ g : 21
: _ _ . _.i . - '66 t~ Z
. l~~Jl~.~. C~ERK ~
' R~sT~.~~C~~ CpUNTY.
. _ Fl.OR1UA
1 FURTHER CERTIFY that I will comply with all other rcquirements of a legal resident of this State.
j
t FURTHER CERTIFY that I have no +ntention to return to my former domi~ile, and I intend to remain in FORT s
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_
~ : ~ s~ ~ R./
. _ x
~ . ' . (Name)
' ~ ~ ~ = Thomas Gauntt
- - . . ;s
~ ;
' ~ ~ • (Address)
~ ~ • ~ ~
. n i'. i
' ~
Sworn to and subscribed before me this 29th day of March ~ ~q 66 _
RQ3ER POITRAS
CLERK CIRCUIT COURT Notary Public
G
8Y C Cy~~_ D.C. My Commission expires
(To b~ sxecuted in duplicate and original filed with Gerk Grcuit Court, snd d~plicate w~th Tax Ass~ssor.)
eooK 141 474
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