HomeMy WebLinkAbout1186 Declaratlon ot Domicile and Cttizenship a
16~145
TO THE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE COUNTY, FIORI~A:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordante and
~n co~formity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of D@trO~t Q211~a1'! _
(City) (State)
and I resided at ?00 3eward 3tT@et However I have changed my domitile
(Street and Number) -
ro and am and have been a bona fide resident of the State of Florida since _ l~~l__ _ _ day of
_DeC9mber ~q 67 , and I reside at st. Luaie COU11trv Club
(Street and Number)
FORT PlERCE, SAINT lUC1E 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 property or business, or relinquishment of employment
at former domicile, remova) of family to new domicile, purchase of home, etc.?
Eatabliehing residence ~
~~LEp AND RECORDED
- ST.IUC~E COU~TF ~D p'
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164145
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'68 FEB 6 PM 2 :03
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I FURTHER CERTIFY that 1 will comply with all other ~equirements of a legal resident of this State.
; I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
= PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_
~ ~
~ :a:~ ~
i J~
. ~ (Name)
-i ~ Russell 8 ~iller
3
. (Address)
- '•,:~Svirom~to and subscribed before me this 6th day of February ~ 19
- ,
.
ROGER POITRAS
- CLERK GIRC IT COURT Notary Public
yy ~~!?L:~[JC-.~i~/
B D.C. My Commission expires
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(To bs executed in duplicate and original filed witl~ Clevk Grcuit Court, and duplicate with Tax Ass~ssor.)
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