HomeMy WebLinkAbout2046 ~
i
De~laratio~ ot ~omicil~ and Citizenship '
15901~
TO THE STATE AND COUNTY TAX ASSESSOR,
1
Sl. IUCIE COUNTY, FLORIDA:
This is my decla~ation of Domicile and Gitizenship in the State of Florida that I am filinq this day in socordants and
~n conformity with Chapte~ 222, Section 222.17, Florida Statutes.
1 was fo~me~ly a legal ~esident of BOliVBt' Net~1 Yol'k
Ki~y~ (Stsro)
;
and I ~esided at = 13~ OleBn SLt'eet Hcwever I hsve changed my domiGile '
(St~eet and Number) i
to and am and have bee~ a bona fide resident of the State of Florida sinte l~t day of
~
20~ Ace. C ~
_ _--J~e , 19~, and 1 reside at .
(Sheet and Number)
FORT PIERCE, SAIN?. IUCIE COUNTY, FLORIDA ~
1
and this statement is to be taken as my declaration of citizenship, actual legal residente and domicile in the State of Hotids.
(Inse~t here any pertinent fads, such as sale of propery or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purthase of home, ~etc.) _ ~
~nter ch~ld in school ~
~ F~CE~ ANp RECO
sr. ~uc~E RDED
RECOpo °U~'. F~,o.
~ERrFiED -
15~1~
_ AUGlt~9:33
=~oGi~
E~ERK CIRCUjT COUqT
;
~
1 FURTHER CERTIFY that I will comply with all other requlrements of a leysl ~esident of this State. ~
I FURTHER CERTIFY that I have no intention to retum to my former domiCile, and I intend to remain in FORT ,
~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
- ~ /
(N )
. - ' Hrs. Kenneth ( I~~?ry ) Aash ;
. _
~ ~
. _ ;
~ (Address) ~
. ji
~I~. ~ i
~~~$worn to and subscribed before me this ~ th day of L~Qust . 19-~2? ~
ROGER rO1TRA5 ~
CIRCUR COURT Notary Public ~
ar.~.Lt.~ ~O ~
gy D.C. My Gommission expires !
(To b~ ~x~cut~d in duplicat~ and ori~inal fil~d witb Cl~elc pra~if Cou~, and duplieata with T~x Asw~or.)
8~~~.67 `~~,~204s
_
=
~