HomeMy WebLinkAbout2627 Declaratio~ ot Dorr~icile and Citisen~ship
ts3~8~,
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORiDA:
This is my decla~ation of Oomicile and Citizenship in the State of Florida that I am filing this day in accordance and
~n co~formity with Chapter 222. Section 222.17, Florida Statutes.
I was forme~ly a legal ~esident of --____11I@~tt _ _Ore¢OII - ~
(City) (State) ;
and i resided at 72~_ Noith COast H~ghM?ay H~Weye~ 1 have changed my domiti~e +
(Street and Number) ~
to and am and have been a bo~a fide resident of the State of Florida since __._18fh-._ _ day of ~
_ AIQYem~, i9
6~, a~d i res~de at _ Causeway Trailer Court
(Street and Number) i
~
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
and this statement is to be taken as my declaration of citizenship, adual legal residence and domicile in the State of Florida.
(Insert here any pe~tinent facts, such as sale of propeny or business, or ~elinquishment of employment ~
at former domicile, removal of family to new domicile, purchase of home, etc.)
3
Establish Residency ~
' FILED ANO RECORDED ~
ST. LUCIE COUNTY. FLA. ~
~2~ CORQ ~~~~I~IED ~
16318'7 - ~
'68 JAN 2 PM Z: 2 2 ~
. ~~~~~.u~~ ;
~ ~ S
CLERK CiRCUIT COURT •
I FURTHER CERTIFY that I will comply with all other requirements of a(egal resident of this State.
:
I FURTHER CERTIFY that 1 have no intention to retum to my former domiGle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. •
i
T
(Name~r. J~ gruce Drever ;
l
~
Z
(Address) '
,
;
Swom to and subxri befo~e•rr~.this 2 nd day of T~LaijC , 19~~ ~
.
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.•J :.v~•~:'~ ~v
ROGER POITR/?S c, ~ r • o .
CLFRK CIRCUIT CQIJlY ' s•, : v_~ Notary Public .
E-- -
- Lr: `
gy _.s ~rE. My Commission expires :
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(To b~ ~x~eut~d ~n duplieaM jkd•wpiMal fil~d with Cl~eic C~r~ri/ ,~nd with Tax Ass~s~or.) ~
~ Ba7K 1~~ PACf ,
; -
t,lo. 13