HomeMy WebLinkAbout0903 Declaration ot Domicile and Citizenship ,
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TO TNE STATE AND COUNTY TAX ASSESSOR, -163~3 .
51. lUC1E COUNTY, FIORIDA: '
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This is my declaration of Uomicile a~d Citizenship in the State of Florida that I am filing this day in accordante and ;
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
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Moorebead Yentucky '
1 was formerly a legal resident of - - -
(City) (Stab)
and 1 resided at _ RS~tCCl Stielt However I have changed my domici~e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since __-____-~8tf+ day of
December ,~9
6?, and 1 ~es~de at 1406 Cortez Blvd~
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA ~
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 fads, such as sale of property or business, or relinquishment of employment
at former domicile, removat of family to new domicite, purchase of home, ett.)
FIt,EO AND RECORDED
Establishing residence ST, I.UC~E COUNTY. FLA. ~
FFCORp VERIFIEp
163~3 '
=-'~8 tI~:Y 30 Pt~ 3: 48
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! c;f';E-i? s-C+!TR:S
I CLERK CIRCUIT COURT
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~ I FURTHER CERTIFY that 1 will oomply with all other requirements of a legal resident of tF~is State.
I FURTHER CERTIFY that I have no intention to retum to my for miti , and I intend to remain in FORT
PIERCE, SAINT:d~~~O~Jf,1TY, FLORIDA, permanently.
~::i C~ '~/i~
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~ - ~ ~ • a = 1~larvin S nley Caudill .
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~ 30th January 68
r Sworn to and subscribed before me this day of . 19
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~ ROGER POITRAS
~ CfRCU1T COUR~ Notary Public
~ g ~ D.C. My ~ommission expires
_ ~To b~ ~x~cuted in duplicaM and ori~inal ~il~d wifh G~ric Circuif Covrf, and dvpli~at~ witb Tax As~s~oa)
~mF e~Kir~o ~AGE VYV
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