HomeMy WebLinkAbout1492 Declaration ot Domicile and Citizenship ~643~2
TO THE STATE ANO COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my decla~ation of Domicile 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.
1 was formerly a legat resident of NCwCO~@IStOWII ~h10
- ~C~ty) - - (State)
and 1 resided at ROVte ~3 _ _ _ _ _ - _ _ . However I have changed my domic.ile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since _ lsth day of
September b8 313 S. 23rd Street
- - - - - - 19-- and I reside at -
(Street and Number)
FORT PIERCE, SAINT LUCIE 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, removal of family to new domicile, purchase of home, etc.)
BSTABLISH RESIDENCB
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f I FURTHER ~ftTIFY that I will comply with all other requirements of a legal resident of this State.
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E I FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and I intend to remain in R~
€ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_ ! l
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a (rvame) Vernon R. Re
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313 S. 23rd Street, Ft. Pierce, Fla.
(Address)
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- . Swtfrti to anyi."subscribed before me this 14th day of - FCbIUBtq , ~q 68 .
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5 ~ ROGER PC~I~ttdS"c
r- CLERK CIRCd URT Notary Public
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F:; By ~ D.C. My Commission expires
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(To be'=executed in duplicate and originsl filed with Cleric Circuit Court, and dupliuts with Tax Assessor.)
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