HomeMy WebLinkAbout0590 Declaration ot Do~nlclle ~nd Cltlzenship
~ 16'?"?'14 ~
TO THE STATE AND tC)IiNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my decla~ation of Domicile and CitiZenship in the State of Fforida that I am filing this day in aooordante and
in conformiy with Chapte~ 222, Section 222.17, Flo~ida Statutes.
I was forme~ly a legal resident of Ar11IIgtOri Helghtd Ill.
(Cify) (Stab)
and 1 resided at 1551 No1^th Geo]~ga StTeet . However 1 have changed my domi~ile
(Street and Number)
to and am a~d have been a bona fide resident of the State of Florida since 4th dsy of
_ ~[~rch , 19 68 , and 1 reside at 'T02 Easter Ave
(St~eet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, aciual legal residence a~d domicile i~ the State of Horida.
(Insert here any pertinent fads, such as sale of property or busineu, or retinquishment of employment
at former domicile, removai of family to new domicile, purchase of home, etc.)
FF~Ep AND REC~R9EE1~~
Bstablishing residence ST. LUCIE COUNTY. ~LA.
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16'7'7'14
'69 JUN 4 Pk : 8q
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~.oc~a ~oi7Ras =
CLERK CIRCUIT COURT
1 FURTHER CERTIFY thet 1 wiil oomply with all other requirements of a leysl resident of this State.
I FURTHER CERTIFY that ! have no intentian to retum to my former domicjle, arid I intend to remain in FORT
PIERCE, SA1NT LUCIE COUNTY, FLORI~A, permanently. '
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,~5'~f+iCnn •to •aYid subscribed before me this ~ th day of Jiine , 19,.~g
; R ER POITRAS
CIRCUIT OURT Notary Public
c~c.t1 ~
8 My Gommission expires
(To b~ ~x~a~fad in duplieab and ori~inal filsd wi~b Cl~~lc pra~it Courf, and dupl~eaN wiN~ Tax A~swor
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