HomeMy WebLinkAbout1745 Decia~ation ~t ~omicile and Citizenship '
TO THE STATE AND COUNTY TAX ASSESSOR, ~~S , J~
Sl. LUGIE ~OUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Flo~ida that 1 am filing this day in aaordance and
in conformity with Chapter 222, Sec~ion 222.17, Florida Statutes.
I was fo~merly a legal ~es~dent of Irvi~gton New Jersey _
(City) (State)
and I resided at 13 _~i1DeS ?~P1aCe _ However I have chsnged my domiCi~e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since __16th_ day of
_March____, ~q 63 , and I reside at 226 fintrada AVe. River Park
(S~~eet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal ~esidence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment ot employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establishing resic~ency
fl~p aNU RECORO~e'„
g~~RECORO vEa~lRiEO~ ~ ~
~
'6 SEP 2T PM 3:02
148'792
R4GER POI7RAS
~ pLERK CIRCUI7 COURT
t
I RJRTHER CERTIFY that I will oomply with al) other requirements of a lega) resident of this Stata.
I FURTHER CERTIFY that I have no intenfion to return to my forme~ domicjle, and 1 intend to remain in FORT E
f
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
_ j,;' ~.-..C~ I ~ `
i' S`t`
: . (Name)
Perc A. Miller Jr
`
~ ~ ~ • . ~ ~ (Address)
~ t c ~~~e~~ ~ ~
~ ' ~ 27th September 66
Sworn to and subscribed before me this day of , 19 •
ROGER POITRAS
CIRCUIT URT Notary Public
a~,c.~t.~
gy D.C. My Commission expires
(To b~ sx~cutsd in duplicate and original ~iled with Gerk Grcuit Courf, and duplicat~ with Tax Asssssor.)
~1fl1(~ _ " t
_ _
- -
_ r>