HomeMy WebLinkAbout2419 Declaration ot Doenicile and Citizenship -16~9~~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
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This is my declaration of Domicile and Citizenship in the State of Florida that 1 am fili~g this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
~ LONG BBAQi CALIP.
I was formerly a legal resident of - -
(C~ty~ (State)
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155? Pacific Ave.
and 1 ~esided at Howeve~ I have changed my domiCile
(Street and Number)
18th
to and am and have been a bona fide resident of the State of Florida since day of
67
August ~t~ 112 Bntrata Ave.
_ _ - - - 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 legat residence and domicile in the State of Florida.
(Inser? here any pertine~t facts, such as sale of property or business, or relinc~uishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
FILING FOR HOI?~ES'TBAD PURPOSBS
FILED AND RECORDE01_
ST. LUCIE COUNTY. FLA.' i
t?F_~'f!f'^ :f= ~.~~.~'D ~
'68 MAR 6 PN 2: 2~ 16
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'-0:~~~~ i~0lTP.: S
CLERK CIRCUIT COURT
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I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this Stata.
1 FURTHER CERTIFY that I have no intention to return to my former domiule, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. t
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y ; , (Name) ;
BENJ~ IN YOST !
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~.$wu~?'n tb ahd subscribed before me this 6th day of ~rch , 19 68 • :'i
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ROGER PO ;
CLERK IRC I COURT Notary Public ~
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By D.C. My Commission expires
(To bs execut in dupliuM and originsl filed with Clerk Grcuit Cour1, and dupliute with Tax Assestor.)
60~K~~O VAGC~~09
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