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HomeMy WebLinkAbout0146 Oe~laration ot Don~icile and ~itisenship TO THE STATE AND CWNTY TAX ASSESSOR, - , ~i. LUCIE COUNTY, FIORIDA: - „1~~84 ~ This is my declaration of Dom~cile a~d ~itizenship in the State of Flo~ida that 1 am filinq this day in sooo~danos and in co~formity with Chapter 222, Sectio~ 222.17, Florida Statutes. 1 was formerly a legal resident of Silvar Sptinp,s Maryland (Ciy) (State) and I ~esided at _ 9118 ~1anCheStCr ROad , .~Wever I havechan~ed my domidle (Sneet and Numbe~) to and am and have been a bona fide resident of the State of Florida since 3rd day of 2404 S 19th Street June _ , ~q 66a~ I reside at (Street and Number) FORT MERCE, SAINT LUCIE COUNTY, RORlOA and this statement is to be taken as my declaration of citizenship, actual legal residenoe and domicile 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.) Establishing residence Ql~p~ _ . ~ECORO VfRI~'~! IEA ~l JAN S P~1 12: 2T fiOGER ~p 5~L8~ ~~RK CIRCUIr COURT ; ~ I I RIRTHER CERTIFY that 1 will comply with al) other requirementt of s le~al resident of this Stste. 1 FURTHER CERTIFY that I have no intention to return to my former domivle, and I intend to remain in FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~~~„~;t,~.,, ~ , : - . .=,;•r:,._- ;:ti..; ~a~~ rL•~. T ri`~~: ' c- _ A. I. Davidson ' r; y ~ L.S _ . ~ : ~ • : ' (Address) .~.~r~~"`_..~_~,~'`" Januar 6? 5 Sw,o w to and subscribed before me this day of _ y , 19 • ; ROGER rORRAS CI UIT COURT _ Notary Public gy D.C. _ My Commiuion expires (To b~ ~ncui~d in duplicat~ and ori~inal fil~e! with ClKk Cira~it Cowrt, and dupticats with Tax Aaato~.) - , _ ~ooK~64 Pa~E ~ 45 _ ~x~ - _ _ _ _ _ - ~ ~ ~ _ e. ~ ~