HomeMy WebLinkAbout0710 ~eclaratio~ ot L1otn~cile ~~d Citize~ship ~
TO THE STATE AN~ COUNTY TAX ASSESSOR, J
si . wciE couNnr. ~~oR~oA: 148i`~
This is my declaration of Domicile and Citizenship in the State of Fiorida that 1 am filing this day in aooordante and
~n conformity with Chapter 222, Section 222.17, Flo~ida Statutes.
1 was formerly a legal resident of Charleston ,~outh Carnling
(City) (State)
and f ~esided at ~ _ Route 1 BOx 185, John *s Island Ho"vever 1 have chanyed my domici~e
(Street and Number)
to and am and have been a bona fide ~esident of the Stste of Florida s~nce 2nd day of
September , 1966 , and i reside at Dixie INobile Homes
(Street and Number)
/
WRT MERCE, S/UNT LUCIE COUNTY, RORlDA
and this statement is to be taken as my declaratio~ of citizenship, actuat lega) residence and domicile in the State of Horida.
(Inse~t here any pertinent facts, such as sale of property or business, or relinquishme~t of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bntering Dannp Lee Pace~i in 2nd Grade -
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~ 1 FURTHER CERTIFY that 1 will aomply with all other requiremenb of a(egal resident of thia State. t
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I FURTHER CERTlFY that 1 have no intention to return to my former domicjle, and I intend to remain in FORT ;
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. i
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,'~y i~~3~{j'"; ; ` (Name)
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~ • ° ~r - James Pacet~
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~~~;`!~;5 •~etid subscribed before me this 6 day of SeP~embe r ~ ~q~.
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~ ROGER POITRAS
~ CIRC GOU Notary Public
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~ 8y • D.C. My ~ommission expires
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~ (To b~ ~x~c~rhd in duplicat~ and ori~Fnal fil~d whb CIKk Circuit Cou~t, and dupliph wifh Tax Assa~or.)
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