HomeMy WebLinkAbout2390 Declaratlon ot Don~icile and Citi:enship
TO THE STATE AND COUNTY TAX ASSESSOR. L59233
Sl. LUCIE COUNTY. FLORIDA: ~
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filin~ this day in acoordanos and
in confo~mity with Chspte~ 222, Section 222.17, Florida Statutes.
I was fo~merly a legal ~esident of ~ettering (Dayton) ~o
(Ci1y) (Stats)
and I resided at ~ 3050 Fail7nont A9enUte . Flcwever I have chan~ed my domidle
! (Street and Number)
to and am and hsve been a bona fide resident of the State of Florida since l~ day of
- : - ~~a c~~a !a/~ I
J~ 6? 1t~2 lO~h Court, ;'~ort St.Lucie
, 19 , and I reside at -
. (Street a~td Number) .
FQRT ~IERCE, SAINT LUCIE COUNTY, RORIDA , ~
,
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and this stateme~t is to be taken as my declaration of citizenship, actual legal residence ~nd domicile in the State of Horlda.
' (Insert here any pertinent facts, such as sale of property or busineu, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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Establishing residence ~ - ~
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I FURTHER CERTIFlf that I will comply with all other requiremenri of a lepal resident of this State.
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, FLORIDA, permanently. -
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y~,~ ~
r-'. ' A;~+'`` Rob ='t D. Mti~levN
. . A~bert D. ~usson ~
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~~'S~`•~l.su~ibed before me this 16 day of w~.~t . 19~•
ROGER rO1TRAS
CIRCUIT COURT Notary Public
gy D.C. _ My Commission expires
(To b~ ~x~c~t~d in duplieai~ and oripinal filsd wilb Clwk CircuM Cove~, and dupliut~ whh Tax As~er.)
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