HomeMy WebLinkAbout2004 ~
Declaratio~ ot DomiCile and Cttizenship (
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TO THE STATE AN~ ~QUNTY TAX ASSESSOR, iFjEj7a~`* ~
51. LUCIE COUNTY, FLORI~A:
This is my declaratio~ of Domicile and Citizenship in the State of Florida that 1 am filing this day i~ acoordance a~d
~m m~formity with Chapter 222, Section 222.17, Flo~ide Statutes.
1 was farme~ly a legal resident of BrOOk1~/Tl NCM York _
_ (City) (Stab)
and 1 resided at _ 66 GOthmi~D Avt!. However 1 have changed my domitile
(Street and Number)
to and am and have been a bona fide ~esident of the State of Florida since _25th__ day of
March 4711 So Ind. River Drive
. _ _ . 19 68 and I reside at
(Street and Number)
;
FORT PtERCE, SAINT LUCIE COUNTY, RORIQA i
and this statement is to be taken as my declaratian of citizenship, actual legal residence and domicile in the State of Flo~ida.
(Insert he~e any peninent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicife, purchase of home, etc.)
RILE~ AND R~CORD~d~ ~
Bstablishing residence 3T. LUCIE COUNTY. l.A:'
RECORO VERIFIED
lss~34
'68 I~IY 2 AM 10:15
ROGER POITRAS
CLERK CIRCUIT COURT
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~ I FURTHER CERTIFY that 1 will comply witfi all other requirements of a legal resident of this State. ~
I FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, $A1~1t ~ ~QUNTY, FIORIDA, permanently. t
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_ . ~ ~ _ ;.Q : Howard J. Kingsland
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~ Sworn to and subscribed before ma this 2nd day of Mt~ ~ ~q 68
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RO~iER rO1TRAS -
CIRCUIT OURT Notary Public
~ gy A'~-~'G ~.C. My Commission expires
(Yo b~ ~aacvl~ in duplicsl~ ~nd ori~fn~ Nl~d whb CIKk Clrcvil Ce~et, and drplical+ wi~h T~c AaM~J
s~~ 171 PAGf ~2
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