HomeMy WebLinkAbout0834 v
Decla~ation ot Domicile and Citizenshlp
TO THE STATE ANO COUNTY TAX ASSESSOR, .
145491
51. lUC1E COUNTY, FLORIDA:
This is my declaratio~ of Oomicile and Citizenship in the State of Flo~ida that 1 am filing this day in aooordance and
in conformity with Chapter 224, Section 22~.17, Florida Statutes.
I was formerly a legal resident of _ ~mptOD _ Vlrgj n~ a _
tCiy) (State)
and 1 resided at 3 Fe ltOn P18C6 However 1 have chsngcd my domiv1e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 2? day of
June . 19 6_, a~ ~ ~es~de ar 142 Ramie Lane, Port St. Luie
(Street and Number)
FORT PI~CE, SAINT LUGIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal reside~ce and domicile in the State of Florida.
(Insert here any pertirent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establishing residecce
Barry Ainsley Lundin will be attending Jusior College
0
. 0 REGOR f~-p''
F~LLUC~E ~ VER1F EO
gT. a~C~RO
, t •
~ 2a ~ ~491 -
b6 14
, ; -.,~~~~~~o~R;
c,~C
1 FURTHER CERTIFY that 1 will comply with all other requirements of a IeQal resident of this State.
1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT.LAICIE. COUNTY, FLORIDA, permanently.
.
. .
.
: ' - e)
. . ~~p~ ~
. . . % . ~ ~ ' ~H~e Joseph Lundin , Jr.
.
' (Address)
~ " • ~
_ . `ti -
Sworn to and subscribed before me this 28 day of T~ne , 19~_.
ROGER POITRAS
CLERK CIRC COURT Notary Public
gy ~ D.C. My Commission expi~es
(To b~ ex~cvbd jn duplicat~ ~nd ori~ioal filed wilh CIKk Cirarit Courf, and dvplicatr wifb Tax Ass~or.)
s~x 149 233 ,
- - r~~~ _ ~ .
~;5~:=~.~~~~~~ - ~y~ ~
~
.zz