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HomeMy WebLinkAbout1081 Declaration ot Domicile and Citlsenship 16407'4 TO THE STATE AND COUNTY TAX ASSESSOR, Sl . LUCIE ~OUNTY, FLORIDA: Ti~is is my declaration of Oomicile and Citizenship in the State of Florida that I am filing this day in aooo~dance and ~n conformily with Chapte~ 222, Section 222.17, Florids Statutes. I was formerly a lega~ resident of Elmhurst New York i (City) (State) ~ nnd 1 resided at _ 93-35 Lamont Avenue . Ftowe~er ~ ha~e chan~ed my domtcile (Street and Number) " ~ ~ to and am and hsve been a bona fide resident of the Stata of Florida since 1St day of August 66 309 Granada Street ~ , 19 and I reside at j (Strnet and Number) E ( ; ~ORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~ ~ and this statement is to be taken as my declaration of citizenship, actual legal residenca and domicile in the State of Horida. ~ (Insert here any perti~ent facts, such as sale of property or business, or relinquishment of employment at former domicile, removal of family to new domicile, purchase of home, etc.) ~ Purchased a home located at 309 Granada Street, ~ort Pierce, Florida. Lot 7, Block 11 of the revised map of Fort Pierce Beach Subdivision. ~ FILED ANO RECORDED ST. LUCIE COUNTY. FLA. ~ RE:COR(~ V~RIFiEa 16407'4 ` '68 FE6 5 AM I O: 3 2 ~ i;4;;E_F ~~OITR~S C~ERK CIRCUIT COURT 1 FURTHER CERTIFY that I will comply with all other requirements of a(e~al resident of this State. • . 1 I FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and 1 intend to remain in FORT ~ PIEi2CE, SAINT LUCIE COUNTY, FLORIDA, permanently. I L~• 1 ~-O • ( ame) D. W. Camacho ~ ~ 309 Granada Street _Ft. Pierce, Ela. ; (Address) ! i . Sworn to and subscribed before me this Sth day of Februsry ~q~~ ~ . ~ ~ I ROGER POITRAS ~ € G.ERK CIRCUIT COURT ~ i t~atery Public ~ , . G"! : ; ~ f > ay D.C. . p ~ , .MY~~miu~ ~cpires h,~ ~ _ ' _ ; i~ _ . :S . ~ i ;'3 . ~J I I.. r ~ ' iON:J4D It~hGl..~n l.tLD yy,' . ~ ~~L'1L1 . u~i.J`C~:.~a~sT ~ l~ . ~ ~ ' (To b~ ~x~eut~d in duplicat~ ~nd orlpinal fil~d wita.. _C1%ile;~";CebK,°and dupliub with Tau /1sws~or.) ~ R ! a~K17o o~io78 ~ ~ . . _ i. ~~,1 - ~~.y i ~ b i , ~ . a.s~". ' yi - w~'~r~. ~r~ . ' . _ . _