HomeMy WebLinkAbout2575 ~ D~cla~~tlo~ ot Doi~nicil• and Citf:~~ship ~
14'747'5
TO THE STATE AND COUNTY TAX ASSESSOR.
Sj. IIJCIE COUNTY, FIORlDA: ~
This is my declaration of Oomicile and Citite~ship in ths State of Florida that 1 am fili~q this day in aooorda~ and -
;n oonformlty with Chaptei 222, Settion 222.17, Florida Statutes. -
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1 was formerly a le~al ~esident of ~ I111tlois
(City) _ (Stats)
g01 Esatcaalda Boad~ 1~arlc~t 8sigbts
and 1 rosided at . However I have chanqed my domidle
. (Sneet and Number) _
ro and am and have bae+~ a bons fide resident of the State of Ftorida sinoe 1~ day of
~t J1~ . 66 509 3audia Dri~e, For~ S`t. Lnaie ~
; 19 , and 1 reside at
(Street and Numbsr)
FORT M~CE, SAIN? LUC{E COUNTY, RORIDA
and this statement is to be faken as my declaration of citizenship, actual tegal residenoe and domicile in the State of ~ids.
qnsert hare any pe~tinent facts, such as sale of property or busineu, or ~elinquishment of employment
st former domicile, mmoval of family to new domicile, purchase of home, etc.)
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R~l.EO AND REEOR9~
ST, IUCiE COUNTI?~ F~
RECORD VER~F~E~
$tte~in~ Dsbra in lOth t~rrad~ ~ ~-~~~o
~ H~obe~t ~in 8th aradR s~~ 8~ Z% ss
• (~nthia in 5th c~rads
« ~ ~a ana~. 14~'47'S -
C~ERK
CIRCU
jRAS
COURT
I
I .
I FURTHER ~ERTIFY that 1 will oomply with all other requimmenh of a leyal resident of this State.
1 FURTHER CERTIFY that 1 have ra intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, fIORIDA, permanentiy.
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~t~` •~;`•~s-,'•:~' f I~Ira. Roberti MaClare
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-~SMre~K~~~'and subscribed before me this 8 day of ~~t , 19 ~
RO~iER ~OiTRAS
CLi~IC UIT C RT Notary Pubiic
gy D.C. My Commiuion expires
,
(To b~ ~c~arhd In duplicst~ and ori~iesl R{~d witl~ Cl~ek Ci~cuk Coue~, and dupli~st~ wifb Tax A~sa~or.) _
~ooK 152 1?4
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