HomeMy WebLinkAbout2718 aclaratlo~ of Domi~il• ~tnd Citisenship 1~324g
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TO THE STATE AND COUNTY TAX ASSESSOR,
Si. LUCIE COUNTY, FLORIOA: ,
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This is my decla~ation of Oomicile and Gitizenst~ip in the State of Florida th8t 1 am filinq this day in r~oordanoe and ~
in confo?mity with Chapter 222, Section 222.17, Florida Stetutes.
I was formerly a tegal resident of 111ent04d ,Terr Jera~v _
(Ci~Y) (St~»)
and I resided at - p n Bn:~_ Rg~h rn 11rjy,! . However I have cha~qsd my domivle
(Street and Number)
ro and am and have been a bona fide resident of the Stste of Florids sinoe 3u1~~_ day of
- Ju~ 19_fi~, and I reside at _ 501 IIlrich fload
(Straet and Number)
FORT MERCE, SAINT lUC1E COUNTY, FLORIDA
and this statement is to be taken as my decla~ation of citizenship~ adual legal reside~ce and domicite in the Staro of Ftorids.
pnse~t here any peninent fads, such as sale of propeny or business, w ~elinquishmint of employm~nt
at former domicile, rRmoval of family b new domicile, purchase of home, etc.)
Tetablieh ~~ency for hoaestead purpoeee.
O PN~ OVNTY ~
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. 168 JA 63~ w ~ ~
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I FURTHER CERTIfY that t wili oomply with alt other requtremenis of a legel residsnt of this State.
I FURTHER ,CERTIFY that 1 have no intention to return to my former domitjle, and I intend to remain in FORT
PlERCE, SAINT LUCIF- COUNTIf, FLORIDA, permanently.
~a 8. Allan `'18ytoII
. (Betty)
(Add~ess) ~
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i~. SntbF~ fb end wbxribed before me this _~th day of dAnuarv 19 .68 ~
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„ CLE~K~tIRCU1T CO ~ Notary Public .
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BY ' D.C. My ~ommisiwn expires
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~To b~ ~x~arNd in dnplical~ and ori~inal fil~d wifl~ Ct~ek Cinarif Cowt, ~nd d~plicat~ wilh Taoc AtMSwr.) ~
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