HomeMy WebLinkAbout2802 Declaration ot Domicll~ and Cltisenship 163316
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TO THE STATE AND COUNTY TAX ASSESSOR.
Sl, tUC1E ~OUNTY, FLORIDA:
This is my declaration of Domicile and Citirenship in the State of Florida that 1 am filiiq this day in aocardanos and
~n conformity with Chapte~ 222, Sect;on 222.17, Florida Statutes.
1 was formerly a legal resident of P~ri ma G~.ZT F10.*idilr
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and 1 resided at -__IYI_ agp~1~S~.eaiPh k08d.~ACL L However 1 hswr thanqed my domid~e ;
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to and am and have been a bona fide resident of the State of Florida since l~th day of
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September , 19~~, and I reside at 18I7 North Federal HiQhw v ~
(Street +end Number) ~
FORT ~I~tCE, SAINT lUC1E COUNTY, RQRIDA ~
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and this statement is to be taken as my declaration of citi=enthip, ectual iegal residenos and domidle in the State of Florlda.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at fo~mer domicile, removal of family to new domicile, purchase of h•~me, etc.)
FILED AND RECORDE~ntering Ralph Ssith in 2 nd Gradt
gT, LUCIE COUNTY, FLA.
REC~C3316 ~ °f s~boo~.
, '68 JAN ~ AM 9: 11
ti~0`,c,?; ~-~~ITP DUftT
CLERK CIRCUI7 C - -
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i Ft1RTNER CERTIFY that I wil) oomply w+th a!! other rsquiremenis of a leQal resident of this State. ~
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1 FURTHER CERTIFY ihat 1 have no intention to retum to my former domic,ite, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA; permanently. +
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(Name) Mrs. Robert S~ith
CBarbara)
_ (Address)
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'~tNiQ~rr~~~~_ subsuibed before me ihis 8t~1 day of Japuary - 19 6$
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_ J,`: ~ C1~ Notary Public
~f?., D.C. My Commiuion expires
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(To b~ ~x~ci+Nd in dupltsat~ and ori~tnal fil~d wilh Cl~k Cira~if Court, and dupliuh wi~ Tax Asw~or.)
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