HomeMy WebLinkAbout0051 Declaration ot Domicile and Citi=enship 163511
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIORIDA:
This is my declaration af Oomicile and Citizenship in ths State of Florida that 1 am filing this day in aooo~danos and
in conformity with Chapter 222, Section 222.17', Florida Slstutes.
1 was formerly a legal ~esident of YOUnt Vernon Ohio
(Ciy) (Sta»)
and 1 resided at ~ ~05~$8Ht SLigBY' }lowevsr ~ have chsnged my domic.ile
(Slreet and' Number)
to and am and have been a bona fide ~esident of the State of Florida since 1Q~h__ day of
T1»R , 19~~, and 1 ro:ide at 610 Wisteria Ane
(Streef and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORi~A
and this statement is to be taken as my declaration of citizenship, ectual legal residence arx! domicile in the State of Ho~.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of emptoyment
at former domicile, removal of family to new domicile, purchase t~f home, etc.)
Eatabliehing residence
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FILED AND R~~pRDEQ
ST, l.UC1E COUNTY. FLA.
CQRD VERIFIED
16351i'
'68 JkN I P 3: 30
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'~0:;~? ~-o: ~ ?-~s
CLERK C1RCUtT COURT
I FURTHER CERTIFY that I will oomply with all other requirementt of a Isya) resident of this State.
1 FURTHER CERTIFY that I have no iniention to return to my tormer domicjle, and 1 intend to remain in FORT
PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently.
_ ~
(Name)
; . Eether E. Lasher
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~~v y~-~cG;~~: ~r ' (Address)
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. ' ,~`~~'•Qcn~t° !~'~lubsuibed before me this day of - Januarv , 19~.8.
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':f•~~'~~~~.~~' C ~ Notary Public
BY D.C. My Commissio~ expires
Ro b~ ~x~evhd in duptiah and ori~inai fit~d with C1KIc Grari~ Govet, and duplieah wi~h Tax Asa~or.)
OR ~ ~
daOK~~ PACE 5~'
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