HomeMy WebLinkAbout2459 Oecl~ration ot Domicile and Cittsenship '
- 163iC~1
TO THE STATE ANO COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filin~ this dsy in ar.oordanos and
~n conformity with Chapter 222, Section 222.17. Florida Statutes.
I was formerly a(ega! ~e:~de~r of Meridan ~nn
~City~ (StaM)
;
197 ohnson Ave. . However i ha~e cha m dom~cile ~
and 1 resided at - Y
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 26th day of
Dec. 67 St~xxis 408 Willows Ave. ~
_ , 19 and ! reside at
(Street a~d Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actval legal re:idence and domitile in the Slate of Horida.
(Insert here any pertinent facts, such as sale of propeny or business, or relinquishment of employment
at former domici~e, removal of family to new domicile, purchase of home, etc.)
Esta~lishing residence t
. :
_ ~,1D ou j~pEp
F~LE~ ~ Y' Fp~.~A~ C~1.
S ; , LUCI V :~'il' 1~0a3~
. ti=z.c~
pt r'r_ : 8
~ ~L3 a~~~
6~
, _
~ ' • : :t~
~~,Y: C1R~~~~
1 RIRTHER CERTIFY that I will comply with all other requiremenri of a leyal resident of this State.
;
i FURTHER CERTIFY that I have no intention to retum to my former domiti~e, and 1 intend to remain i~s FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. '
~
. P. . .
~ :
~ . Q~ ;
: i i . ~'%/j -
- " /'1 / i
~',e..,' (Name ;
_ _ -~,=r. John A ~'itzgibbons '
, _ . . - - -w; ~
s
:
`n . : c ' Oi1~t~t)
' = Viola S. Fitzgibbons
I%'{`~'';;• ~-•0•~`- 2 9th llec. 67
~.Swc~kn t~.pod subscribed before me this day of , 19 .
~
Roe~+e rom~?s
CIRCUIT COURT _ Notary Pubtic
Gl~c.~,l~Q~ O
gy D.C. My Commiss'ron expires
(To b~ ~x~cut~d in duplicat~ and ori~pnal Bl~d wilh Cl~ric Cinuif Courf, and duplical~ wjth Tax Aa~aor.)
; a~16y p~2~41