HomeMy WebLinkAbout2725 Declaration ot Domicile and Cilizenship _
163255 .
TO THE STATE AND COUNTY TAX 4SSESSOR, '
Sl. LUCIE COUNTY, FLORIDA~
This is my declaration of Domicile and Citize~ship i~ the State of Florida that 1 am filing this day in accordance and
,n confo~mity w~th Chapter 222, Section 222.17, Florida Statutes.
Pittsbur Penn
1 was formerly a ;egal resident of - - - - - -
~C;ty~ (State)
and t resided at _ 236 Kaplat! AV! . However ! hav~ changed rny daniC~l~
(Street and Numbe~)
ro a~d am and have been a bona fide resident of the State oi Flo~ida since 17~b day of ~
~
,
February , and 1 reside ar 413 _Willows Aye. ~ River park _ ~
- - - - - (Street and Number) {
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FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. ;
(Insert here any pertinent facts, such as sale of prope~ty or business, or relinquisfiment of employment
at former domicile, removal of famity to new domicile, purchase of home, etc.) •
~
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Establishing residence
~,NO RECORDED ;
5~LLUC~E C v pj
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1Z~.:C~ND !
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I FURTHER CERTIFY that 1 w':I) comply with atl other requirements of a legat resident of this State. ~
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I FURTHER CERTIFY that I have no intention to return to my former domiule, and I intend to remain in FORT
PIERCE, SAI~(~;.LL~AE;;~O!)NTY, FLORIDA, pe~manently.
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~ _ V , ,,s • ~ • / ~ ' - : ~ - - ~Name) - - - ~
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' _ ` (A~dress)
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Swom to and subscribea before me this _____4th day of J~?SUij? 19 68 i
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ROGER POITRAS - ~
C RK CIRCUIT COURt Notary Public ~
~ -~~.tt . 1
gy - D.C. My Commission expires
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- (To be exec~ted in duplicate and original filed with Clerlc Grcuit Court, anct duplicaM with Tax Assessor.) '
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` ~169 ~~7~p6 ~
No. 13 ' ' . . .