HomeMy WebLinkAbout0895 ~eclaration ot Domtcile ~nd Citi:enship
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TO THE STATE AND COUNTY TAX ASSESSOR, ~ ;
51. lUC1E COUNTY, FLORIDA: ~
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This is my declaration of Oomiciie and Citizenship in the State of ftorida that ! am filirp this day In aooordante and s
~n conformiy with Chapter 222, Section 222.17, Florida Statutes.
1 was formerl a I B~~~x ~IY N.J.
y egal resident of
(Cty) (Ste») ~
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and I resided at _9 Thel~oso Rd. . However I have chanyed my domic3le
(Street and Number)
to and am and have been a bona fide resident of ths Stste of Fiorida since l8t day of
AUGIIST 607 N. 9th St.
- , 19 , end I reside at
(Street and Number)
FORT f1ERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declarotion of citizenship, actual legal residenoe and domidle in the Stats of Hotida. !
;!nse~t here any pertinent facts, such as aale of property or business, or relinquishment of employment
at fo~mer domicile, ~emovai of family to new domicile, purchsse of home, stc.)
FILING FOR H(M ESTF,~D PQFt'FU.gFS
~tEO AMO
8T ECO~~~u~j~0
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1 FURTHER CERTIFY that 1 will oompty with all other raquimmenis of a le~el resident of thi: State.
, 1 FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I inte~d to remain in FORT (
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PIERCE, SAINT lUC1E COUNTY, FLORlDA, permanently.
, 1 ~ ~
: ; : . (Mame)
o:ii~trro;~ ,
~ ~ C~~ii,~~';; _ I~V. HARRY GORDON
~ J. ..~~J' i~• ~~•.••~,~/i•:
' - ~ - ~ . ~ (Address)
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:;%,~-~~Wb~p to~~acW~uburibed before me this ~3 day of J~~~ 19 6? .
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` C U11 COURT Notary Public
gY D.C. My Commiuion expires
Ro b~ aaeuhd in dupticNr and ori~inal fi{~d wifh Cl~rlc Ci~wi~ Carrt, and dupliqh wHh Tax As~or.)
~00~~~4 n~ 894 .
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