HomeMy WebLinkAbout2711 Deciaration ot Domicile and Cit~zenship ~
~ 149381
TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State ot Florida that I am filing this day in accordance and
in conformity with Chapter 222, Sectian 222.17, Florida Statutes.
Aubrun New York
I was formerly a legal resident of -
(City) (State)
and I resided at 12 Park P18C@ _ _ liov,~ever I have changed my domic~ile
(Street and Numbe~)
to and am and'have been a bona fide resident of the State of Florida since ___18_ day of
Uctober 66 322 N 14th Street
_ - _ - - 19---_, and 1 reside at ,
(Street and Number)
~
I
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and ~omicile in the State of Fiorida.
(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.)
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Bntering child in Sth Grade
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1 FURTHER CERTIFY that I will comply with all other requirements of a(egaf resident of this State.
I FURTHER CERTIFY that I have ~o intention to return to my former domiGile, and I intend to remain in FORT •
PIERCE, SAtNT LUCIE COUNTY, FLORIDA, permanently.
ti:~tt~/1r, ~ ~
Gi lber t E. Cu l len
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, (Name)
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'~f •^'~t and subscribed before me this 21 day of Uctober , ~q 6~
:~wcKrl •
ROGER POITRAS
CLFItK RCUIT COURT Notary Public
gy D.C. My Commission expires
(To b~ ~xecuMd in duplicat~ and ori9inal ~iled witb G~rk Grwit Court, and dupficats with Tax Ass~or.)
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