HomeMy WebLinkAbout2400 Decfaration ot Domicfle and Citizenship ~53~53
TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Fio~ida that 1 am filin~ this dey in scoo~dancs and
~n confo~mity with Chapter 222, Section 21~2.17, Florida Statutes.
1 was fo~merly a legal ~esident of PittSbOrO I~'orth Car ~liliiL
(City) (SfaM)
and I resided at p•O•BOx 674 Flcwevaf i have changed my domicjle
(Street and Number)
to and am and have been a bona fide resident of the State of Flotida since 1St day of
July 66 124 E~ Prima Yista Blvd
_ , 19 and 1 reside at
(Street and Number)
fORT PIERCE, SAIN? LUCIE COUNTY, RORIDA
and this statement is to be taken as my detlarotion of citizenship, actual le~al residence and domicile in the Stab of Horida. ~
(Insert here any pertinent facts, such as ssle of property or business, or relinquishment of emptoyment
at former domicile, removal of family to new domicile, purchase of home, etc.)
FILED qNp RECQRD
ST ECQ'Pp VFR
tFrEd
Establishing residence ~sl fEB 27 PM
2s
CLERK CIp ~~OITR ~s3a53
RCUrT CoURT
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1 FURTHER CERTIFY that 1 will oomply with all other raquiremenfs of a leya) resident of thia State.
1 FURTHER CERTIFY that I have no intention to retum to my former domi~ile, and I intend to remain in FORT _
PIERCE, SA(MX'~~CI~'EOUNTY, FLORIDA, permanently. -
' • / ~-~.<<-_-•--~~- ~t.
_ _ f i~'
_ :r - ,i,~_;::~.~~= , (Name)
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' _ ~;,a Clif ford W. Outwater
~ . .
~ , (Address) .
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Sworn to and subscribed before me this 27 day of February , 19 67 . ~
ROGER POITRAS
CI UIT COURT Notary Public
gy • D.C. My Commission expires
(To b~ ~x~cut~d in dupliub and o~i~inal ~il~d with q~rlc Circuit Couirt, and dupllcat~ with T~x Ass~oor.)
~ aQOK 164 P~~t 23 96
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