HomeMy WebLinkAbout0544 N
D~cla~atio~ ot Domlclla and Citi:enship -i51860
TO THE STATE AND COUNTY TAX ASSESSOR,
51. IUCiE GOUNTY, FLORIDA:
This is my detla~atlon of Oomicite and Citizen:hip in the State of Florida that I am filing fhis day in aoootds~oe and
in conformity with Chapter 222, Section 222.17. Florida Statutet.
1 was formeriy a leyal rosident of ~iat P'leasant Beaah Ne~ Jeraey
(Cfty) (Stats)
and I r~idsd at ~iladelphia Ave . Flowevsr 1 have charqad my domlcile
(St~eet and Number)
lat
ro and ~m and have been a bona fide resident of the Staro of Florida since d+Y ~
Jwae , t~ , and 1 rKtde at 1~ ~~g ~e~ PO~ st. ~ncie
(Stroet s~d Numbe~)
FORT MiRCl, SAINT LtKI! COUNTY, KORIDA
and this statement is to be tak~n as my decla~ation of citizsnship, actual legal residence and domicile in the State of Horida.
pnsert hsn any perfinent facts, such es sale of property or busineas, or relinquishment of employme~t -
at former domicile, removal of family to ~ew domicile, purchase of homs, etc.)
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Establishing residence -
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1 FURTHER CHtTIFY thst I wlll oomply wHfi all other requiremenri of a le~al roskknt of thi: Stste.
I FURtHER CfRTIFY that f hsve no intention to retum to my former domicJle, and 1 intend to remein in FORT
. L~CiE-EOUNTY, fLORIDA, permenently. l`L~ Y
PIERC~ _ ~
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~~s~ °:;~•7 ~ Morton Van ~`~eter & Hary Van Meter
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Sw~orn to end wbscribed befom me this 13 day of a~~~ - 19 .
ROOER ~OITRAf
~ Notary PuWk
gy ~.C. M~i Commiuion expiros
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