HomeMy WebLinkAbout0616 Declaration ot Oomicil• and Citf:~~ship ~
TO THE STATE AND COUNTY TAX ASSESSOR, 151948
Si. LUCIE COUNTY. RORIDA:
This is my declaratio~ of Domicils ar~d Citiu~ship in th~ Stat~ of Horida that I am filin~ this day in sooordu~ou and
in oo~formity with Chapt~r Z22, Section 222.17, Florids Statutts.
I was formerly a(pa) resident of ChiC ag0 I 1 1 i~n; s
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and 1 r~ided at 5843 Whipple Street ~ ~~v~cha~p~d my domidle
(Strat and NumbK)
to and am and hevs been a bo~a fide r~idsnt of the Stats of Florida :ina 1S ~y ~
March 66 226 Camino Street
, 19 , and I r~ide at
(Strest and Numb~r)
FoRT N~, sAINT tuc1E CouNTY, RORIDA Po rt St . Luc i e
and this statement is to be taken as my daclsration of citiunship, actual leqal residenas and domidls in the Stat~ of Horida.
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pnsert here any pertinent fads, such as sale of propKty or business, or rolinquishm~nt of en?pioym~nt _
at former domicils, removal of family to new domicile, purchase of home, stc.)
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Establishing residence -
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I FURTHER CERTIFY that i will oomply with sll other r~quirements of a le~ai rosidsnt of this Sbte. '
I FURTHER CERTIFY that I have no intentwn to return to my former dornicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUfVTIf. FLORIDA, permanently. ~
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~~y`'~?, 7 `~•;i;:'`. (Name)
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i * r(~~: ' Marvin Humphrey
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=~~.'.e:-~. ~it: bsd before me this ib ~Y Januarq " , 19 6?
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aoc~ae rom~?s -
~ Notary Publk
gy • D.C. My Commissan expirss
(Te b~ ar~cYNd iw drpWcaN and e~i~inal fiNd with Cl~ek CircYif Cewf, aad dvplicab wilh Tax AsMNa.)
$0~164 ~ 614
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