HomeMy WebLinkAbout1068 Dec~aration ot Domic~ie and Citisenship ~~~23
TO THE STATE AND COUNTY TAX ASSESSOR. LiC N°lsa° F' R~t~+dt
Sl. IIKIE COUNTY, FIORI~A: ~ ~Z~
This is-my declaration of Domicile and Citizensh+p in the State of Florida that 1 am filiny thia ~ay in aawdanoe and
in to~formity with Chapter 222, Settion 222.17, Florida Statutes.
I was formerly a legal resident of ~altimore i~°~rvls;nd
(City) (State)
and 1 resided ar ~?44 _~.^~~lton A~~en~.ze . However 1 havechanged my domitile
(Street and Number)
to and•a~n.arui have~been a bona.fide-resident of the State of Florida since thP iR~h day of
A ril ~~g Will Lot 1~1. Block 54'i Fort St. L~~cie
_ p , , and I reside at ~
(Street and Number)
FORT MERCE, SAINT LUCIE COUNTY, RORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legal residenoe and 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, ~emoval of family to new domicile, purchase of home, etc.)
I am a~e~:ber of the ~J.S. Army and ha~ e been for the past 24 years.
I ha~~-e not resi3ed in r^~yr former donicile and legal residence on my
own volition for ~he past 24 yeaxs. '
I hati°e purchased land in Florida and intend to settle there when
retired from my Army servi~e.
~~~y per~aner.~ mailing address is: Yost Ofiice Box 3690~
Fort Pierce, r^lorida 334~0.
I have change3 my official military records accordin~ly.
F'Ii.EB AND ltECOR8E9~_
ST. LUCIE COUNTY. FIA.'
RFCORD 165~~3
~
; '68 JUN I ~ ~ ~ ~ y
~
~ -~P~
rtoc~~ ~~TRas
CLERK CIRCUIT COURT
1 FURTHER CERTIFY that I will oomply witfi all other raquirements of a leqa) resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and t intend to ~emain in FORT
PIERCE, SAINT LUCIE COUNTY, FI.ORIDA, permane~tly. ~
~ BJN
*JELSd~1 F. RIT i~~t?
~ (Name)
n-(;_ ~O% 3~~~, fQ2't ri~rce, ; l~rid~
~ (Address) . . . 3 31~ r r~ ~
(~t. Col. '`.S.Army~ . ~
~ 217 Fope A~ _ e, For~`'~~,~A'it.tn~'orth Ks~ ~
da of lq,-~c.~
Sworn to and wbxribed before r»~ this y
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R~R - i ~ _
CLERK C~CUR COURT Notary Public ,
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ay D.C. My Gommiuion ~xpir~s .
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R~ w~ M~ awd ~i~M~l fil~ wi~ Ci~ic Ckwi1 C~w~, aud ~ wMl~ Tax Aw~~.~ _
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