HomeMy WebLinkAbout2609 1631~3
Daciaratian ot Dornicile and Citizenship
f0 THE STATE AND COUNTY TAX ASSESSOR.
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Sl. lUC1E COUNTY, FIORtDA: f
This is my declaratio~ of Oomicile and Citiienship in the State of Florida that 1 am filing this day in accordante and ~
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~n conformity with Chapter 222, Section 222.17, Florida Statutes.
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I was formerly a legal resident of ____.__~r~~II3b911I$~l__-__ _-~tgt
V-
i-r-QoiniB _
~~;ty~ (Staro)
and I ~esided at __1Q~~@~ TerraCe A~2t 3 However I have changed my domicjle
(Street and Number) ~
to and am and have been a bona fide resident of the State of Florida since 2LS3 _ day of
November, ~q 67~ and I reside at __~31~5.' ?~x 3286
(Street and Number)
FORT PIERCE, SAINT LUGIE COUNTY, RORIOA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establish Residency for homestead purposes
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FILEO ~ ND QUN
~Y
~F A•
ST. LU C
~~_C~Zn `;ERIFIED
' 1631'73 , _0
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~~8 ~aca 2 i i •
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::L,::.~: i~i]`.ii'~ S .
CLERK Ctr~CU~Y COURT
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I FURTHER CERTIFY that 1 will comply with all other requiremenis of a legal resident of this State. i
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I FURTHER CERTIFY that I hav~ no intention to return to my former domiGle, and I intend to remain in FORT ~
PIERCE, SAINT L~:iC.tE COUNTY, FLORIDA, permanently_
(Name) ~ZZ~1sX][Q
Grahav K. Bullock
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Y e ~ ( 41~
~wpr++ to~ and. subscribed before me this 2ad day of A rv , 19~$
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RO(fER rO1TRAS:: -
- -:r aq~iitK CIRCdIt.~GOU Notary Public
gy - D.C_ My Commission expires
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~o b~ ~x~cu1~d iw dupliut~ and oriyinal ~ilsd with ClKlc Grwit Co~rt. and dup{ieat~ with Tax Ass~ssor.) +
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° ?~Jo. 13 '