HomeMy WebLinkAbout2551 Declaratlon ot Domicile and Citizenship
ls~ass
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in acmrdance and
in co~formity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of -B~ue POiAt I, I_ $ew YOrk _
~ (City) (State)
and I resided at -1~~. _~i _E_. However I have changed my domiCi~e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ____26th__ day of
Temporary
F@llr , 19~~_, and I reside at _.~A»~P~A~ Trai l pr park
11A1'~T-
(Street and Number)
FORT PIERCE, SAINT IUCIE COUNTY, FIORIDA
and this statement is to be taken as my declaration of citizenship, actual lega) residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile,-pufeF~ase of home, etc.)
Establishfng reaidence
Purchasing a home 36~Indian River DriQ~e
FILED AND RECOROED
ST. LUCIE COUt:TY. FL.A.
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68 h1A,R 1 I AM 9. 46
. .
. :~OITF::,S
CLFRK CIRCUIT COURT
I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
. , r. ~-~C~
r--,.1 (Name)
_ _ .
' ~ . , . Joseph W. Her~og
, _
~ (Address)
Swo~n to and subscribed before me this ~.~+1~ day of ~arn), , 19_b$.
~
ROGER POITRAS i
LERK CIRCUiT COURT Notary Public ~
i
By O.C. My Commission expi~es ~
(To be executed in duplicaM and ori~insl ~iled with Clerk Grcuit Court, and dupliub with Tax Asses:or.)
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