HomeMy WebLinkAbout2719 16324s
~ecl~rution ot Domicif~a a~d Cltizenship
i
TO THE STATE AND COUNTY TAX ASSESSOR, !
Sl . LUCIE COUNTY, fIORIDA: .
This is my declaratio~ of Domicile and Cit~zenship in the State of Ftorida that 1 am filing this day in aooordance and
~n confwmity w~th Chapter ~22, Section 2~2.17, Florida Statutes.
1 was formerly a legal resident of ______IPSWICH _ MA.SSA(~IUSBI'TS ~ _ ;
(Ciry) (State) ~
- ~
~
and I resided at 1_~~B_ STRHBT However 1 have changed my domivle
(Street and Number) ~
to and am and have been a bona fide ~esident of the State of florida since _____28th _ day of
FEBRUARY 6? 138 PLACITA (~OURT
- _ . 19 and 1 reside at
(Sireet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, adual legal residence and domicile in the State of Horida.
(Insert here any pertinent fads, such as sale of praperty or business, or relinquishment of employment
at former domttite, removaT"o`f family to new domicile, purchase of home, etc.)
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I RJRTHER CERTIFY tfiat 1 will compty with all other requirements of a legal resident of this State.
I FURTHER CERTIFY ihat I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
1 .
(Name)
JOHN W. HOPKIN
138 PUCITA COURT ~
' . • (Address)
J',`rri t~.~v 'cbscribed before me this 4th da of J~U~Y ~ 19 68
~;S~ro o~ nfl f _ Y ;
_ ~ 4~: . _ ~
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Roo~ie ~~C~=`
Ci~E~!lC~RCl~lj`'COUQT Notary Public ~
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8y D.C. My Commission exp~res - !
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(To b~ ~x~cuhd in duplicat~ snd ori~inal Rl~d with CINk ircvit Cou~f, and duplicat~ with Tax Ats~tsor.)
~1~ ~~~00
No. 13 . .