HomeMy WebLinkAbout0217 Declaration ot ~omiclle and Ciitzenship _
TO THE ST9TE ANO COUNTY TAX ASSESSOR, 15~~~
51. LUCIE COUNTY. FLORIOA: -
This is my declsrotion of Oomicile and Citizenship in the State of Florida that ! am filin~ this day in accordAnos a~d
in oonformity with Chapter 222, Settio~ 222.17, Fioride ~atutes.
1~vas formerly a legal ~esident of UlBllesley Massachusetts
(City) (S1at~)
and I ~esided at 1 MellOtl Road . However 1 have chanysd my domic~le
($troet and Number)
to and sm a~d have been s bona fide ~eside~t of tJ~e State of Florida since 25 day of
October , ~q 66, and I reside at 2996 I~+bnnin~ Side Blvd
(Street a~d Numb~z)
Port St. Lu~ie
FORT M~CE, SAINT LUCIE COUNTY, RORIDA _ ~
and this statement is to be taken as my declaration of citizenship, actval lega) residenae and domicile in the State of Florida.
pnsert here any pertinent facts, such as sale of properfy or business, or relinquishment of employment
- at former domicile, removal of family to new domicile, purchsse of home, etc.)
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f~lEO ANO RECORD `
Establishing r~sidence ~T• LUCIE COUNTY, ~j,
_ REC~Rp VERIFIEb
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~ '61 !l~F~ - 6 PM t2: 22
15163'~ ~
~o~~•a aolrRaS
CIERK CIRCUIT COURT
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1 FURTHER CERTIFY that I will oomply with all ather ~~quimmsnn of s lepal ~esident of this Stsfe. _
I FURTHER CERTIFY thst I have no intention ro.: •um to my former domivle, and 1 iMend to remain in FORT
PIERt~,,SA1NT WCIE COUNTY, FLORIDA, permansntly." ~
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j~~. '`1• ~~r''~. - (Wame)
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' - ~ ~ . - s~~' Aif red A. Lattanzi
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. . , +`F` 4`
' •p'•. ~t~ _ 6 - aanuary 196?
~..S,~K4~~ jb:~tid subsuibed before me this day of -
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ROG~ 'OITRAS ~
R ~p~ Notary Public . -
gy ' O.C. My Gommiuion expires ,
(Te b~ ~oc~eul~d In duplic,als aa! o~inal A{~d witl~ C1~ic Ci~wit Co~~, and ~ with Tax Aa~aer.)
~ ~ ~ ~164 ~ 216
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