HomeMy WebLinkAbout0194 Otcl~~ation ot Oomi~ll~ and Citirc~nship
161655
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FlORIOA: ~ - ~
This is my declaration of Domicile snd ~tizanship in ths Stat~ oE Flarida that 1 am fitin~ this day in aooo~dance and
~n oonform~iy w~sh Chapter 222. Section 224.17, Florida Statut~s.
#~z3~ II.LIBOI3
I was formerly a legal rssident o
(City) ~Sts»)
and i residad at _-~2 Be1,0UIIt . However 1 havs chan~sd my domidle
(Stnet and NumbK)
to and am and have been a bona fide ~esident of ths Stste of florida since 3rd day of
~ovemb@r ~q 67, a~ ~ reside at 1029 Trinidad dve. .
~ (Street and Nun±ber)
PO1tT r1~tCE, SAINT LUCIE COUNTY, KO~tIDA
and this statement is to be takan es my declaration of citizenship, attuel ieqal residenos and domicile in the State of Fbrids.
qnsert here any pertinent facts, such as sale of property or bu:ineu, or ralinquishment of employment ~
at former domicile, removal of family to naw domicile, purchase of home, etc.) t
$stabliehing =eeid~nas ~
i
FIlEO AND RECQRDED
ST. LUCIE COUNTY. FtA.
• ~ RECORQ `lERIFIED ;
` 161655 ~ '
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'61 NOV 13 AM 10:43 ~
RQ;,~r~. ~'OtTRMS ;
{ CLERK CfRCUIT COURT E
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I FURTHER CERTIFY that 1 will oomply witfi all other requlremenri of a lepal resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former domitile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanentiy. -
j;
,,,L : ~ , $dward ~a"'~artla
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~~waf?.!~,etnd~'wbxribed before me this 13th day of 8ovember , 19 67 .
~ ~
ROGER rOiTRAS -
CIRCUR OURT Notary Public ~
~
gy ~ O.C. My Commiuion expires E
. i
it
1T~ b~ ~xuwt~d ie dupWcat~ and original fil~d whh Clwk Ciraih Court, aed dvplicaN with Tax Aae~o'a i
UR ~
s~K16q P~ 1~3.
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