HomeMy WebLinkAbout1345 Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~~~~',2
51. IUCIE COUNTY, FIORIDA:
7his is my declaration of Domicile and Citizenship in the State of Florida that i am filing this day in accorda~ce and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of ~harleBtOri W. Yirginia _
(City) (State)
and 1 cesided at 101fi COVe 1ifi8y Dr1ve ~Weve~ I have changed my domitile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ___-12th day of
-___.e~11~,y . 19~~ , and I reside at 201 Gardenia
(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 ihe State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employme~t
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establishing residence
FII.ED AND RECORDED`
ST. LUCIE COUP=TY. FLA.
~f.Ct~F?^ •~ERIF:FD
164262
'68 FEB 9 PM ~ : 0~~~
_
t. ~'r'L ~ r•QtT RNb
CLERK CIRCUIT COURT
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~ 1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
!
~ I fURTHER CERTIFY that I have no intention to return to my former domi~ile, and I intend to remain in FORT
PIERCE, SAINT LUC,I~:;C~NTY, FLORIDA, permanently.
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= _ ~ 'v ~ ' ~ ! cG,_ J? ~ (Name)
- Jack Thoma$ Kelly
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Sworn'tA and subscribed before me this 9th day of February ~ 19 .
- ,
ROGER POITRAS
K CIRCUIT COU T Notary Public
~?,c-~c~c~/ ~
By D.C. My Commission expires
(To be executed in duplicats and original filed with Glerk Grcuit Court, snd dupliute with Tax Assessor.)
i3 BWKir~o P~UC~~~ .
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