HomeMy WebLinkAbout2978 Dectarat~o~ ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSES.Sn~. L6S36O
Sl. LUCIE C~UNTY, FLORIDA:
This is my declaration of Dom~ule a~d Cit:ze~ship in the State of Ffo~ida that 1 am fili~g this day in accordance and
in conformity with Chapter 222, Sectip,n 122.i7, Florid~ Statutes_
` ti'reenwood
I was formerly a legal resideni IA1ii''M$
- - -
(City) (State)
~
315 Smart Street ~
and I resided at - - . - . Nowever I have cha~ged my domi~ile ~
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since _ Stb- day of
June 67_, and 1 reside at _3__OS F?IROSA BLVD~
- - - - - 19_ .
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLOAIDA
and this statement is to be taken as my deciaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, sv:~ as sale of property or business, or relinquishment of employment
at former domicile, removal of farr~~ly to new domicile, purchase of home, etc.)
~ Establishing res~dence and anplying for homestead
- FILEO AN~J RECORDED`-
ST. IUCIE ~aVS~TY. FLA.
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~ lsssso
! + 24 ~ ~ : 53
f 68 MAR
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F ~ ~~,s
3 . •
CLERK CiRCUtT COURT
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~ I FURTHER CERTIFY ihat I w+ll ccmply with all other requirements of a legal resident of this State.
_
~
~ I FURTHER CERTIFY that I have no intention to return to my former domi4le, and I intend to remain in FORT
~
PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently.
,
~ .
~ ' ~
' - (Na e)
~ • David Joseph Burton
: . .
(Address)
~ Swom to and subscribed before me this ~~t~ day of March , 19~ j
-
-f.
' ROGER POITRAS
F.:
CLERK CIRCU T COURT Notary Public
~
~Y
~ gy Cz-~~ ~~t~ D.C. My Cur.:mission expires
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(To be sxecuted in duplicsM snd originsl ~ilsd with Cl~rk Grcuit Cou~f, and duplicats with Tax Asssssor.)
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