HomeMy WebLinkAbout0294 Declaratlon ot Domicile and Citizenship
~ 16558`7
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, fIORIDA:
This is my declarotion of Domicile and Citizenship in the State of Floride that 1 am filing i is day in aaordance And
in conformity with Chapter 22?, Section 222.17, Florida Statvtas.-
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1 was formerly a legal resident of Tro R~ve=s _ r~
SC.~IISla _
KitY) (St~te)
a~d I resided at 2110 Adiut3 _ . However 1 have chsrped my domicjle
(St~eet and Number)
to aRd am and have been a bona fide resid:snt of the State of Florida since a9th day of
67 s
Deceaber ~ 2501 North Pederal Highway~ Box 26
, 19 and I reside at _
(Street and Number)
f4RT 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 Horida.
(Insert here any pehinent fads, such as sale of p~opery o~ business, or ~elinquishment of employment
at former domitile, removal of family to new domicile, purchase of home, etc.)
ESTABLISH RESIDENCE
F!l.EO AND RECOROEDi - ;
ST, I.UCIE CQUNTY. FLA:
p~ rnc>n c~» ~ f
'L ~~S ` t
'68 MAR 27 AM 9: 40
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,•.il;:L~+ .'V~TRi.~$
CLERK CiRCUIT COURT
1 FURTHER CERTIFY that 1 wil! aomplY with all other requi~ements of a laQal resident of this State.
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I FURTHER CERTIFY that I have no intention to retum to my former domi4le, and-t_iniend to remain in fORT 4
PfERCE, SAINT LUCIE COUNTY, FLORI~A, permanently. ~
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~ : ~i`'L : ' . (Name)
' . ~,PSt -
„ - i _
t • • 1 ~ .
; ; ~2 - 2501 North Pederai HiRhMSy
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J~ • - • : C~ (~dfe3f~
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~~'`Swbrn to snd subsuibed befora me this 27th day of - M~rCh ~q_~. ~
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ROG~R ~OlTRAS
~~uR Notary Public
BY . My ~ommiuio~ expires
R. .a.w1~ M~e,a~. ,ur ..i~n.~ !~1 wiN~ Cf..lc ciraiM c~ow+. .wd d~plis.~. wi~ Taac As..«..a
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