HomeMy WebLinkAbout0469 Decl~ratio~ ot Domicil~ and CitEzinship 161845
TO THE STAfE AND COUNTY TAX ASSESSOR,
S1. lUC1E ~OUNlTY, FLORiDA:
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This is my declaration of Ocmici~e and Citizenship in the Stats of Florida that 1 am filinq this dsy in eooordanos and ~
~n conformity with Chapte~ 222, Section 2~2.17, Florida Statutes. ~
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1 was forme~ly a legal resident of F~~;+sQds~~ N~Y V~r~ ~
(City) (Steta)
and I ~esided at -~H~i?~hOrnc StY@!~ . However I hsve charpsc! my domkile
(StrNt and Numb~r)
ro and am and have been a bona fide ~esident of the State of Florida since 19th day af
_ Noveaber ,~q 67 , t~ ~ ~eside at . 5005 San DieRO A~enue
(Street and Number)
FORT PIERCE, SAINT LUCIE COI~NTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal +esidence and domicile in fhe State of Ho~ids.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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Bstering Doaglas G. Briske in lOth grade
Caailla J. Briste in 7th grade
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' RECORDED Chester S~ Brisl~e,in 6th grade
F1LE0 AN COUN?Y. FLA•
ST•c~~~ F~~o - Teresa J. Briske in 2nd grade ~
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='~ITR:.S
CL~ RK C~RCUIT COURT
I RIRTHER CHtTIFY that 1 will aomply with all other requirerr~ents of a le~al res'idsnt of this State.
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I FURTHER CERTIFY that I have no intention to retum to my former domi4le, and I intend to remain in FOitT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ;
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(Name)Chester S. Briske ~
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(Address) ~
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20th Novesbes
Sworn~tp~~nd,sy,~rfbed before me this day of . 1~-. ~
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:~_y~~ rtpy~ _ Notary PuElic ~
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ay D.C. My Commission expires
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(To b~ ~if~•Iii~duppeal~ aed ori~ind fil~d witi~ Cl~ek Gnvk Covet, and duplicat~ wiTh Tax As~or.)
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