HomeMy WebLinkAbout1525 Declaration ot Domicile and Citizenshlp y.~~$~,Q
TO THE STATE AND COUNTY TAX ASSESSOR,
Si . IUCIE ~OUNTY, FLORIDA:
This is my decla~ation of Domicile and Citizenship in the State of Flo~ida that I am filirp this dey in soo~rdance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident ofH anilton Ohio
~City~ (State)
and I resided at _ 937 DaytOn Street . However 1 hsve chan~ed my domidle
(Street and Number)
to and am a~d have been a bona fide resident of the State of Florida since 30th day of
Janaury ,~q 67 and I ~eside at 121 Bonit a Court '
~ (Straet and Number)
s
FORT rIERCE, SAINT LUCIE COUNTY, RORIOA '
and this statement is to be~ taken as my declaration of citizenship, actual leyai residenoe and domicile In the Stete of Horida.
(Insert he~e any pertinent facts, such as sale of property or business, or relinqui:hment of employment
st former domicile, removal of family to naw domicile, purthsse of home, ett.)
~ntering Teresa in the 2nd grade ~
;
~r Gayle Jr High FIt,EO AND RECORp p= f
Gary sT~
ECO~RD VERIFr~ R~' ~
't Richard in H=,igh School js~~~
~t FEB siPN ~:sg
ROGER ~~OITRQS
~LERK CIRCUIT COURT
i
i
~ 1 FURTHER CHtTiFY that 1 wiil aomply with all other ~equiremsnts of a le~al residsnt of this State.
1 FURTHER CERTIFY that I have no intention to retum to my former domicale, and 1 intend to remain in FORT
PIERCE, SAIN~;i,l3~lE. COUNTY, FLORIDA, permanently.
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_ ~ ~ P ~ Faye edecke
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. Febs 67
. Sworn to and subscribed before me this 6th day of . 19 •
ROGER POITRAS
CIRCUR OURT Notary Public
ir
gy D.C. My Gomm~ssion exp es
(To b~ ~arbd in dupliul~ and oriyinal fil~d wi* Cl~rk Gra~it Coort, and dupli~ah wilb Tax AsNaor.) ~
. ao~164 ~1523 `
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