HomeMy WebLinkAbout2691 t~ealaration ot Domicile and Citlze~ship _
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LU~IE COUNTY, FlOR10A: !
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This is my declaration of Oomicile and Citizenship in the State of Florida that 1 am filing this day in aooo~danoe and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
North Lhicago Illinoia.
1 was fo~merly a legal resident of
(City) (Stah)
and I resided at _ 1T15 ArgOn Drive However 1 have chan~ed my domiciie
(Street and Number)
to and am and hsve been a bona fide resident of the State of Florida since 13th dsy of
_ 'july , 196~ , and I ~e:ide at 2001 SoLth 29th street
(Sheet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declarotion of citizenship, attual legal residence and domitile in the Stab of Horida.
(Insert here any pertinent facts, such as sale of property or busineu, or relirsquishm~snt of employment
at former domicile, removal of family to new domicile, purchsse of home, etc.)
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Establishing residence
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1 RJRTHER CERTIFY thst 1 will comply with all other requirements of a le9a) resident of this State.
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I FURTHER CERTIFY that I have no intention to retur~ to my former domiCile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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. ~ Bdward ~ Mi l~ler
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't, '~~,and subsuibed befwe me this 3id day of .~8nu8rj( ~ , 19~_- ;
Sv1?4rfl. to
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ROGER POI~itAS :
f.IRCUR COURT Notary Public s
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gy D.C. My Commiuion expires
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(To b~ ~x~cuhd in dupliut~ and ori~inal fil~d with Cl~ek Grwit CouA, and duplicata wiTh Tax Aa~ssor.)
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