HomeMy WebLinkAbout1362 Declaration ot Domicil• and Citi:enship jr~85,~:~2
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TO THE STATE AND GOUNTY TAX ASSESSOR, ;
Sl. WCIE COUNTY, FIORIDA: ~
This is my declaration of Domicile and Citizenship i~ ths State of Florida that I am filin~ this day in aooordena and i
~n oonformity with Chapter ZZ2, Settion 222.17, Florida Statutes.
I wss formerly a legal resident of ffist Berl~ n Pennsylvatiis
(City) ` (Stat~)
and 1 ~esidad at - R'D~~ . Howevsr 1 have chan~ed my domidle
' (Street and ~ Numbe~)
to and em and have been a bona fide resident of the State of Florida sinte 25~ day of ~
J~ - 6? Rt 2 Bo~c 132 , Oid Di=le ~ig~x~r
_ , 19 , and I reside st
(Street and Number)
FORT ~I~KE, SAINT LtlCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legat residence snd domicile in the State of Horida.
(Insert here any pe~tinent fatts, such as sale of property or business, or relinqui:hment of employmsnt 1
,
at fo~mer domicile, rerr+oval of family to new domidle, purchase of home, ett.)
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F~lEO AND RECORDE~ `
ST. WCIE COUNTY. h'LA, ~
RECORD VERIFIEO
E~tat,~lishing residence _ -1SSSS~ ,
'6T JU~ 2T p~1 12: 13
Q~$
RO~Ei? POITRAS
CLERK CIRCUIT COURT
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1 FURTHER GERTIFY that I will aomply with all other ~eqviremenri of a(epai resident of thi: State.
1 FURTHER CERTIFY that 1 have no intention to retum to my ~former domicjle, and ! intend to remain in FORT
PIERCE, SAINT LUCIE COUPlTY, FLORIDA, permanently.
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r (Name) ,
r\:- -'~~Ti~ • ,
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~ . ~t • ` ' : . ~ ~ Ra1ph E. Reicher~ & Irene Reiche~t
~ _ f ~ _ - (Address)
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1~111y
'S'vVo~-~to ~.'sulist~ibed before me this ~ day of . 19~.
a~~.,..:;~.
ROGER P0ITRAS
CLFRK CIRCUR COURT Notary Public
gy D.C. My Commiss'wn expi~es
(To b~ ~aart~d in dvpliut~ and ori~inai fil~d wilh Cl~elc pra~if Couh, aed dupfl~ah wi~b Tax Aas~s~a
~ d~K~61 PACE~~ ~
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