HomeMy WebLinkAbout2280 Decla~ation ot Domicile and Citlzenship 149~,2~
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TO THE STATE AND COUNTY TAX ASSESSOR; ~
Sl. lUC1E COUNTY, FLORIDA: ~
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This is my declaration of Domicile and Citizenship in the State of Flo~ida that 1 am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes. 3
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I was formerly a legal ~es~der,t of . _ _ Plainview _ _ _ New York _
(C;ty) (State)
14 Freder ick Drive
and I resided at _ . However I have changed my domic,~le
(Street and Number)
to and am and have been a bona fide resident of the State of Florida sinc 19th _ day of
~25 -I~iomar II=ive,--
Au~ust 66 Ri~t~~BxicHH~x$~H~SitxBux~tx
- - - _ 19---, a~d I reside at -
(Street and Number)
Port St~Lucie ~
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicite 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.)
ST~iuc E
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RECO
RD VER~~EO~.
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~66 OCT J 1 p~ ,
~4~i 3 . S1
Establishing residence ~IERK~`F''~?;
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~~R~~~T COURT
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I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and 1 intend to remain in FORT
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PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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,•r.~t~':, f
. ~!Z. . - ~ .
. . ' (Name)
.
- - . Albert Scoggins
~ - ~ (Address)
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` Sworn to ar+d subscribed before me this 11 day of Oc tobe r ~ 19 66
ROGER POITRAS
CLERK CIR IT COURT Notary Public
gy D.C. My Commission expires
(To be executed in duplicate and originsl filed with Cletk Circuit Court, snd duplicate with Tax Asse~sor.)
BOOK ~~J(! PACE 47?
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