HomeMy WebLinkAbout2585 Decla~atio~ of Domicile and Citiz~nship ~
TO THE STATE AND COUNTY TAX ASSESSOR, ~59~6
Sl. LUCIE COUNTY, FLORIDA: ~
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This is my declaratio~ of Domicile and Citizenship in ths State of Florida that 1 am filinq this dsy in aaorda~cs and
;n conformity with Chapter 222, Section 222.17, Florida Statutes. .
I was fo~merly a legal ~esident of ~~dale VixgiYLia -
~ (City) (Ststs)
b959
and I resided at _ ~~eriCali A`ive ~M,evsr I heve chan~ed my domic3le
(Street and Numbe~)
to and am and have been a bona fide resident of the Stats of Florida sinoe - 26th dsy of
H~ 67 1911-8 Delaxare Ave. ~
_ , 19 , and I reside at .
- (Street and Number) ;
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actuaf legal residence and domitile in the Stete of Horida. '
(Insert here any pe~tinent fads, such as sale of property or business, or relinquiahment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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F~iteriYg Dale Jay Clarlc 5yY'. First Grade
A~ REC `
ST, LUC~E COUNTy~~' ~
REC4RD ~RIFtEO~'
~T a~ 59~66 ~
~ 23 ~ ~ ~ 26 i
CLER~`~'~ '"~rTR~g `
K CIRCU~j COURT -
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~ 1 FURTHER CEftTIFY that I will compty with all other requiremenh of a leqal resident of this State.
I FURTHER CERTIFY that I have no intention to retum to my forme~ domiG~e, and I intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. •
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~,,~~~~~~t~rttrli;~ (Name) i
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:'A~', 1911-B De].atiare Ave.
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:~;3worrt tA•b~ ~bscribed before me this 23~ y lue
~at , 19
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ROGER rO1TRA5
CIRCU:T~„~OI!!Ci Notary Public
gy D.C. My Commission expires
~To b~ ~z~evt~d ~n duplieab and o~i~inal fil~d wilh Cf~elc Grevi/ Coue~, snd dupiiuN with Tax Aa~or.)
a~Ki67 ~2585
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