HomeMy WebLinkAbout1431 ~ Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, 164314
Sl. IUCIE GOUNTY, FLORIDA:
This is my deciaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in aaordante and .
in conformity with Chapter 222, Section 222.17, Flo~ida Statutes.
New Jersey
I was forme~ly a legal resident of _~V~
~C;ty~ (State)
Rt 10 Mt. Fert1 . However 1 havechan ed m domicile
and I resided at - 9 Y
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 7th___ day of
__F~~_. 19
68 , and I reside ar _623 Beach Ave.
(Street and Number)
FORT PIERCE, SAi~IT LUCIE COUNTY, FIORIDA
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 fads, such as sale of property or business, o~ relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bstablishing residence gT~~
CaE COUNTY. FLA~
RE.COR~ V~RIF'FD
164314
'68 fEB 13 AMI 10:2q
~OGE:~ P01TRA5
CLERK CIRCUIT COURT
I FURTHER CERTIFY that I will comply with all other requirements of a lega) resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domic.ile, and f intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ `
• , ti (Name)
~ ~ . ohn F Casey
_ ~c. : ' ~'y ~ ' -
_ ~ J ~ : _ /~~c .
: . _ Katherin«a~sey
' 68
' Februarq
''C~$i~orn~t~i~subscribed before me this 13tb day of , 19 •
ROGER POITRAS
K CIRCUIT C URT Notary Public
~~~-GG ~fi
gy D.C. My Commission expires
(To be ex~cuted in dupliute snd originsl Rled with Clerlc Grcuit Court, snd duplicste with Tax Assassor.)
gO~K~ ~U PACE~~~~
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