HomeMy WebLinkAbout1471 Decla~ation ot Domiclle and Citizenship
-164342
TO THE STATE AND COUNTY TAX ASSESSOR,
51 lUC1E COUNTY, FLORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
;n conformity with Chapter 222, Section 222.17, Florida Statutes.
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I was formerly a legal ~esident of LOS _ A.IIge18S _ C811fOY'IIi8
~C;ty~ (State)
and 1 resided at -__4?00 W AV8 ^ 42 However 1 have changed my domiale
(Street and Number)
loth
~o and am and have been a bona fide resident of the State of Florida since day of
July_- ~9
b?_, and 1 .?eside at - 3'S7 ~elton Drive
(Street and Number)
PORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal reside+nce and domicile in the State of Florida.
(Insert here any pertinent facts, such as safe of property or business, or relinquishment of employment
at forme~ domicile, removal of family to :tiew domicile, purchase of home, etc.) '
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Eatablishing reaidence ~ F~LED AND RfCORD
ST, LUC1~ COUNT EDi
r>- ..~+t` 1~-R! Ffj~A'
'68 FEB 1s~342
14 AM 9: z 0
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~tERK `'O1TR,•,S
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E CIRCUtT COURT
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domic.ile, and I intend to remain in FORT
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~ PIEQCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ • , ~ /lJ~i+ ,G(~~ o~ ~
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~ - ' ~ (Name)
~ ' ~ , ~ ~ ~argaret L. Phillipa ( ldrs Billy~
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. ! _ ~ (Address)
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W~' • ' 14th 68
~ Sworn to and subscribed before me this day of Feb• ~ 19
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ROGER POItRAS
CIRCUIT CoURT Notary Public
Sq.,. J~ ,
Yy~~~ [ ~
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ey _ D.C. My Commission expires '
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(To bs oxecuted in dupliute snd original filed with Clerk Cirwit Court, and duplicate with Tax Assessor.)
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