HomeMy WebLinkAbout2723 163~253
Oecla~atlon of Domicile and Citise~ship
TO THE STATE AND COUNTY TAX ASSEaSOR. -
Sl. LUCIE ~OUNTY, FLORIDA:
This is my declaration of Oomicile and Citi:enship in the State of Florida that I am fi~ing this dsy in aooo~dance a~d ;
~n conformity with Chaptar 22Z, Section 222.17, Florida Statutes. . {
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I was formcrly a legaf resident of New Hide Park Nex Yorl~
(City) (State)
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artd 1 ~esided at 304 Ll0118Id Blvd~ However 1 have changed my domitile 1
(Street and Number) f
19th f
ro and am and have been a bona fide resident of the State of Florida since - day of
J{~ly 67 166 S.~. Bntrada Aoe. ~
19 and I reside at
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, fLORI~A
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or busineu, or relinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.)
Esta~lishing residence
FIIED AND RECOROEO ~
ST. LUCIE COUNTY. FLA.
RE:COF?;? ~lERIFIED
' 163253
'68 J~tl 4 PM ! 2: 0 3
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i ~~u~TR.•.s I
' CLERK CIRCUIT COURT ~
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' I RJRTHER ~ERTIFY that I will oomply with all other requirements of a le~al resident of this State. ~
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I FURTHER CERTIFY that 1 have no intention to ~etum to my former domiale, an~ 1 intend to remain in FORT !
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ^ ~
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,Swoc~'tp.a.~r~!'~wbscribed before me this 4th day of Ja~uarq ~ 19 68
ROGER rO1TRAS
CLERK CIRCUIT COURT Notary Public
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--~~.ec.[~ i
gy O.C. My Commission expi~es f
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(To b~ ~x~cvhd in duplicah and orisinal Rl~d witb Cl~k Cirarit Court, and dupliesb with Tax As~o?.) :
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No, 13 - -
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