HomeMy WebLinkAbout1457 Decia~~tion ot Dor„icil~ a~d Citizenship
. !
152464 ~
TO THE STATE AND COUNTY TAX ASSESSOR, ~
51. LUCIE COUNTY, FIORIDA:
This is my decla~ation of Domicile and CiYizenship in ths State of Florida that 1 am filinq this day i~ aooordanos a~d
im m~formiy with Chapter 222, Section 222.17, Flo~ids Statutes.
1 was formerly a legal resident of Barbertan OhiO
(City) (Stah)
and I resided at _ 3552_ JOhnsOZ] Road . However 1 have chsn~ed my domivle
(Street and ~s?mber)
to and am and have been a bona fide resident of the State of Floride sirxe lSt dsy of
February , ~q 6 and ~ reside at ~tt 4 Box 580 .lenkins Road
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORiDA
and this statement is to be taken as my declaration of citizenship, actual leqal residence and domidle in the State of Horida.
(Insert here any pe~tinent facts, such as sale of property or business, or relinquishment of employment
st former domicile, removal of family to ~ew domicile, purchsse of home, ett.)
~ntering two children in school
Ep pND REC~~~• ~
s
~i.uc+ Rp ~uN ;
RECO ~Ea4s~
t
152 ~
~ g ' 36 ;
+gi ~E8 3 !
o~~ ~
~
' :tov4~ '"~~t C~VR~
~ C~Rr( CIRCV1t
I
~
I RIRTHER CERTIFY that I will oomply with all other requirements of a layal resident of this Stab.
f
. ;
I Ft1RTH~R CERTIFY that 1 have no intention to retum to my former domiCile, and I intend to remain in FORT ~
~
ti , - ,
PI~RCEi ~Ad1YT•~114~~E QQtJNTY, FLORIDA, permanently. ~
~
~ . ~
` J• : J~~ ~r' ~ CG ~ ':t . . I
. . , ~ . a 4
.
= ? ' L libo~'i~ttie ~
_ ; inda ~
r' ~ 4 ~ ;
~ ~ •G~
~ ~
~ ~ ~ . . • . (Address)
~ `
Sworn to and s~bscribed before me this 3rd day of February ~ ~q 67, !
~ ~
ROGER rORRAS
CIRCUIT RT Notary Public
ou.~u~ f
gy D.C. My ~ommission expires
~
;
t
Qo b~ pc~eul~d in duplicat~ and ori~inal fil~d whh G~rk Cirwh Court, and duplkat~ with Tax Att~sor.) '
~xi64 ~14 ~
55
. ~
, ~ . - -
~ x _ ~ ~ :
- ~
_