HomeMy WebLinkAbout0830 Dacla~a~tion ot Don~icil~ a~d Citi:enship
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TO THE STATE AND COUNTY TAX ASSESSOR, ~v^+~~ ~
51. IUCIE COUNTY, FLORI~A: '
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This is my decla~ation of Oomicile and Citize~ship in ths State of Florida thst 1 am filin~ ihis day in aaoordance ans! ;
~n oo~formity with Chapte~ 222, Sectio~ 222.17, Florida Statutss. '
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1 was forme~ly a legal ~esident of A811811d BentucYy 1
(City) (Stass) ~
and i ~esided at 2028 D81tO~i Str@Qt .~vrever I havs chan9ac! eny domidle
~ (Street and Numbed
ro e.~d am and have been a bona fide resident of the Stats of Florida since 22nd day of
xosl~n
_ ~o~em?~sr , i9~., and 1 reside at ?n~ n~z;~a sve. -
(Street and Numbsr) ~
FORT MERCE, SAINT IUCIE COUNTY, fLOR10A ~
and this statement is to be taken as my daclaration of citizenship, actual legal residence and domidls in the Stab of Horlda.
(Insert he~e any pertinent facts, such as sale of property or busineu, or relinquishment of employment
at former domicile, removal of family to new domicile, purthase of home, atc.) ~
t
Establiahing residence ~
FtLED AND RECORDED ~
sT~ ECO,RD VER FYED~~ . ~
16204g
' ~T NOV 21 A~I ~0: 0
ROGER POlTR,~S
CLERK CIRCUIT COURT
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1 RJRTHER G~RTIFY that 1 will aomply witfi all other requirements of a legal resident of this State.
1 ftlRTNEJt- TIFY that I have no intention to retum to my former domitjle, and I intend to remain in ~ORT
s~~_
si~7:~J
PIEStC~:`,~IN~-~1~1~ ~QL~NTY, FLORIDA, permanently. -
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, ~::i Q ' - (Name)
~ ~n' ~ ~w:'?-r•,: - Jamea 0. ~ond
_.a ~ ~ ~E•' • - }
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. • ~ , ~
~ ~ ~;.r; (Address)
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Sworn to and subsuibed before me this 27th d3y of Hovember , 19~.
ROGER POiTR!?S
CIRCUR COUR? Notary Public
gy D.C. My Commission expires
~-~o b~ ~x~cvl~d in d~liuta and oei~ind fibd wilh CIKIc Grarit Court, ~nd duplicat~ with Tax At~or.)
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