HomeMy WebLinkAbout1618 ~eclaration ot Domicile and Citise~ship ~
TO THE STATE ANO COUNTY TAX ASSESSOR. 14f J~3
Sl. IUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in actordante and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
Natick Mass.
1 was formerly a legat resident of ___~_._~____.T__ _ -
~C;ty~ (State)
and I resided at 33 P12~l1 St~_ However 1 have changed my domiG~e
~ (Street and Number)
to and am and have been a bona fide resident of the State of Florida since _ 8tb____ day of
Julq _ , ~q66 and I reside at ~8 palm Ave.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declarotion of citize~ship, actual legal residence and domicile in the State of Florida. _
(Insert here any pertinent fads, such as sale of properry or business, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bntering person in school
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I FURTHER CERTIFY that I will comply with all other requirements of a(egal resident of this State.
FHbi~r ~E•RTI~Y that I have no intention to return to my former domic.ile, and I interid to remain in FORT t
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PIERC~;~~~,1~~NTY, FLORIUA, permanently. -
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4'~} ~=;J.~ Bernard H. Zilch
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Sworn to and subscribed before me this 18~ day of .j» 1 ~ ~q 66.
.
ROGER POITRAS
CLERK CIRCUIT COURT Notary Public
6y O.C. My Commission expires
(To b~ ~xxuted in duplicah ar~d ori~insl filed with Cl~rlc Circuit Cour1, and duplicat~ with 7ax Ass~ssor.)
BooK 150 417
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