HomeMy WebLinkAbout1434 ;
146845 ~
DeCla~ation ot Don~icile and Citlsenship ~
TO THE STATE AND COUNTY TAX ASSESSOR, ;
Sl . IUCIE COUN FIORIDA: '
This is my declaration of Domicile and Citize~ship in the State of Florida that I am filing this day in accordance and :
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was fo~merly a legal resident of ._'$uWptel _ C8iO11T18 _ i
(City) (State) ~
_
and 1 resided at 26 _CheilDe _St~_____ _ . 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 5th day of
,lune ~q 66, and I reside at ___?06 S. 13th f S~. F
(Street and Number)
f
fORT PIERCE, SAINT LUCIE COUNTY, FLORIDA '
and this statement is to be taken as my decla~ation of citizenship, adual legal 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 new domicile, purchase of home, etc.)
Entering two children in School
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FILED AND RECORDED
ST. LUCIE COUNTY. FLA.
RECGR~ VERIFIED ~
, I 3 AM ' 28
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146845
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CLERK CIRCUI; COURT _
I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my forme~ domicjle, and I intend to remain in FORT
PIERCE, SAlt~~t~lf~(E COUNTY, FLORIDA, permanently_
~ ` "J•• "'v ~ Allen S Mason
_.~~~';4J~v`,;. = cG/;. (Name)
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Sworn to and subxribed before me this 13th day of ~tlly ~~q 66
ROGER POITRAS
CLERK CIR IT COURT Notary Public
By D.C_ My Commission expires
(To be executed in dupliute snd original filed with Clerk Grcuit Couirt, snd duplicats with Tax Assessor.)
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