HomeMy WebLinkAbout2711 Oeclaration ot Qomiclle a~d Cititenship ,
TO THE STATE AND CQUNTY TAX ASSESSOR, ist~
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51 _ IUCIE COUNTY, FLORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that 1 am fili~g this day in accordanoe a~d
~n conformity with Chapter 222, Section 2?4.17, Florida Statutes.
1 was formerly a legal ~esident of _____Q~ggt _ _ ~t.~r~s _
Kity) (State)
and 1 resided at ,._Z2~ 11TQrth Celee~al However I have changed my domicjle
(Street and Number) ~
to arxl am and have been a bona fide ~esident of the State of Florida since ___~Qfh____-_, day of
~ Holidty Inn
---~p.femb~r, 19.~Z, and I ~eside at G~ncral Det;v~•rv _(t~•~ r:r; tv)
(Street and Numbef)
FORT PIERCE, SAINT LUCtE COUNT1f, fLOitIDA
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and this statement is to be taken as my declaration of citiZenship, actual legal residence and domicile in the State of Ho~ida. ,
(Inse~t here any pertinent facts, such as sale of properiy or business, or reiinquishment of employment
at former domicile, ~emoval of family to ~ew domicile, purchase of home, etc.)
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Entering cbildren in school ~
Will be renting as soon as we find a house.
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FILEO ANO RECOROED • '
, ST. I.UCIE COUNTY. Fl.A.
RECORD VERIFIED
'68 JAN ~i A~I ~Q : Z
6324~
i:~~: F: ~=UITR:.S
CLERK CIRCUIT COURT
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I FURTHER GERTIFY that I will oomply with all o'her requirements of a lega) resident of this State. ~
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1 FURTHER CERTIFY that I have no intention to ~eturn to my former domitile, and I intend to remain in FORT ~
PIERCE, SAtNT IUCIE COUNTY, FtORIDA, permanently. .
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~0~~/'f.0 , L~(/ - ~LJ . GG~ ~/~'7Olli' ~7i
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(Nameyllrs. M~. W. Ptudhom~e ~
CGlenda)
' Gen~rat n.s7+varv ~
' (Address) ~
.'v~.t~ :C~'Jfi,'',
`3~wom to afyi~
subssribed before me this 4th day of nuary ~q~_.
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` ~ ~~K C~~t'~ Notary Public
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; gY D.C. My Commissio~ expires ~
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(To b~ ~oc~ev~ad in dupliu» and oripinal ~il~d whh Cl~ek Cira~t Court, and duplieah with Tax Aa~stor.)
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