HomeMy WebLinkAbout0473 Declaration ot Domiciie a~d Cltizenshlp 165694
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TO THE STATE AND COUNTY TAX ASSESSOR,
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Sl. IUCIE COUNTY, FLORIDA: +
This is my declaration of Domicile and Citizenship in the State of Flo~ida that I am filing this day in aooordance and
in conformity with Chapte~ 222, Section 222.17, Florida Statutas.
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1 was fo~merly a legal resident of W81~01! Mass. _ I
(City) (Stab)
and I rasided at ~ 12 HOlly RoBd . However 1 hava changed my domicjle
(Sireet and Number)
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to and am and have been a bona fide resident of the State of Florida since - 18th day of ~
F
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~rch 68 3413 Sunrise Blvd
, 19 , artd I reside at ~
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
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and this s~atement is to be taken as my declaration of citizenship, actual lega! residence and domicile in ~he State of Ho~ida. ~
(Insert here any pe~tinent fads, such as sale of p~operty or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bntering 2 children in elementary scbool j.sss~4
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FILEO ANp R~COROED
ST. LUC~c ~~V~TY. F
LA.
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~ ~ '~g APR I~Uy g; 2 0
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ERK C14~UIT CQURT
1 FURTHER CERTIFlf that I will oomply with al! other requirements of a lepal residen? of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in FORT
PIER4E, SAINY~~U~IE~CQ~INTY, FLORIDA, permanently.
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Sworn to and suksx~ibed before me ihis lst day of April ~9 68
ROGER PORRAS
CIRCUIT COURT Notary Public
gY a"'~'~'G ~ D.C. My Commission expi~es
(To b~ ~x~cut~d in duplicat~ and ori~inal fil~d with Cl~rk CircuN Coue~, and duplicat~ wjlh Tax Atw~sr.)
aooKZ71 PACE 4?3
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