HomeMy WebLinkAbout2091 166'ygS
Decla~atlon ot Domicile an~! Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY~ FIORIDA:
This is my declarotion of Oomiciie and Citizenship i~ the State of Flarida that 1 am filing this day in aooordante and
~n conformity with Chapte? 222, Section 222.17, Florida Statutes.
I was formerly a tegal resident of NeM~dC PiZY ~ L. I ~ Nev Yorlc
(CitY) IStab)
and 1 resided at _~,Q~~Ngrth S-th S-t~CeE~ _ . However 1 have changed my domicjle
(Street a~d Number)
to and am and have been a bona fide resident of the State of Ftorida since 7~t~_ day. of
_ Nove~ber , 19 6?, a~d i res~de ai 403 Popiar Avenue
(Sheet and Number)
FORT PIERCE, SJ11NT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence a~d domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicite, purchase of home, etc.)
~stablish resideace
built a new hoae on Pop~ar Avenue
FI~EO AND RECOROED~
S t. LUCIE COUNTY. FLA.
RECQRD ~'ERlFlFD
i66'795
'68 MAY 3 PM I: Sq
~ - "
iiOvEK ;•UITR~S
CLERK CIRCUIT COURT
I FURTHER ~ERTIFY that I will canply with all other requi~ements of a leflal resident of this State.
I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FtORIDA, permanently.
~ ` `
~~J~
(Name~illisa Bsier
(Address)
Swwn to snd subscribed before me this 3rd day of _ ~ap , 19_~,$
RO~ilR- ?~TRA~ :
; Notary Public ,
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8Y , D.C. My Commission ~xpires
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