HomeMy WebLinkAbout0559 ~5`79'?'8
D~claratlon ot Domicil~ and Citis~nship
TO THE STATE AND COUNTY TAX A.SSESSOR, ~ ^
Sl. IiJCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Giti=enship in the State of Florida that 1 am fili~p thi: day in aooordenos and
in conformity with Chapter 222, Section Z2Z.17, Elorida Statut~s.
.
,
1 was formerly a legal resident of ~~•ti`i~~?t~~+ ~~r J~a~rr---
(CttY) (Statr)
and 1 resided at ~ 1'S5 South I.in~Il~ Av~IIU• . HowevK 1 hsw chanpsd my domWle
. (Stro~t and Numbsr)
ro and am and hava been a bona fide resident of the Stsh of ~Fioride sinae ?
S+ti+ ~Y ~
October , 19 66, a~ i ~
(Street and Number ~ ere~~
- pla.
I~ORT MQCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizanship, actusl la~al residenoe a~d domicils in the State of Horida.
(Inse~t here any pertinent facts, such ea aale of prop~ry o~ business, or relinquishment of employma~t
at former domicile, removsl of family to nsw domidle, purchase of home, etc.)
Estsbli~h r~oid~ncy
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1 RIRTHER C62TIFY that I will oomply wlth all oN~er ~equirements of a(epal restdent of fhis Stah. -
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i FURTHER CERTIFY that I have no intention to retum to my former domiCjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORI~A, permanently.
. ~
~a""°~ Edwin 8. g~e~ler
, (Addres:)
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~~''~1~„~`';;~ 67
•-.Stiy~oe~*t8=and subsaibsd before me this 13th day of July - 19 . }
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` :~_.[l~ Cp1~RT Notary Public
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g~ - - D.C. My Commisiwn expiros
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(Te b~ ~uarl~d i~ dup~cN~ and oei~inal fll~d whb Cl~ek Ci~w~if Cewf, and wifl~ Tax At~a
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