HomeMy WebLinkAbout2658 Deciaration ot Domicil• and Citizsnship -~53?23~ ~
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TO THE STATE AND COUNTY TAX ASSESSOR,
Si . LUCIE COUI~Y, FLt~RIDA:
This is my declaration of Domicile and Citize~ship in ths Stats of Florida that 1 am filin~ thi: day in saoordance a~d
in conformity with Chapte~ 222, Section 222.17, Florida Statutes.
Fayetteville North Carolina
I was formeriy a legal rosident of
~~ity~ (Stah)
and 1 ~esided at _ 1532 DOVer COUrt ,~~„~e~er I have chanqsd my domidle
(Street and Numbe~)
to and am and have been a bona fide ~esident of the State of Florids since 3 day of
March 67 1116 S. Ocean Drive
, 19 , and 1 rsside at
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTIf, RORIDA
and this statement is to be taken as my declaration of citizenship, sctual leyal residena and domidle in the State of Horida.
(Inse?t here any pertinent fads, such as sale of propetty or business, or relinquishment of employmsnt
at forme~ domicile, removal of family to new domicile, purchase of home, etc.)
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FILEO qNp ~
ST, l.U~tE ~
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RECORD VERI Ep~." ~
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Bstablising residence
Ro~e~ ~53~~
CLERK CIR ~OITR,~S
CUIT ~p~RT
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I FURTHER CERTIFY that I wiil aomply with ail other requiremenri of a lepal reside~t of thi: State.
1 FURTHER CERTIFY that 1 have no intention to retum to my former. domicjle, and I intend to remain in FORT
PiERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. '
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,yl'~~
` ~ • (Name)
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3 =Y~ - B. R. Walker ~
* ~ - - ' ` (Address) ~
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:~~!.~'t~t,a• h~'j~~ : ;
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~~'~~~t~tliacribed before me this 6 day of March , 19_~7 i
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~ ro~u?s
~ C ~pV~ Notary Public
gy D.C. My Commission expires ~
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(To b~ ~x~w1~d in d~plicab and o~tnal filad w~hl~ Cl~ek Grark Court, and duplical~ wHh Tax AsMS~or.) ~
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600K1fi4 PACE2655 `
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