HomeMy WebLinkAbout2468 - Declaration ot Dorr~icil~ and Citizenship ~~g95'7
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IU~IE ~OUNTY, FIORIDA:
This is my decla~ation of Oomicile snd Citi=enship in the State of Florida that 1 am filiny this day in aoo~rdanos and
in conformity with Chapte~ 222, Section 222.17, Florida Statutes.
I was fo~merly a legal resident of ~STOA _ MASS.
~C;~y~ (State)
and 1 resid~d at 18 (~1e21bur21i e Rd . However I have changed my domic~le
(Straet and Number)
ro and am anc! ha~~ been a bona fide resident of the Stats of Florida since 15th day of
J~• , 19b8 , and 1 ~eside at 885 Airosa Blvd.
. (Sheet snd Number) -
FORT r1ERCE, SAINT LUC1E COUNTY, RORIDA '
and this statement is to be taken as my declaretion of citizenship, actual legal residence and aomicilQ,in the State of Hotida.
(lnsert here any pertinent facts, suth as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
To establish legal residency--presently in Military service-
~
sT~
CIE C UN~TY.~FL~q~~ -
, ECORO V~R~FIED
~ i~sss~
'68 JUL 22 ~I! 10 t 27 _
~
~0~£R POiTRaS ~
~LERK CIRCUIT COURT.
I RJRTHER GHtTIFY that I will comply with atl other requiremenb of a le~al resident of thi: State. •
I FURTHER CERTIFY that 1 have no intention to return to my former domiqle, and I intend to remain in FORT
PIERCE, SAtNT LUCIE COUNTY, FLORIDA, permanently.
~ ;r ^ .
r~
: ' :~tits:~t:':r... l
,;``~\~n~~GV~T_~ C~~~4~f ~a~~
` v~.:,~`.'i:..' •-c,,'
~~::~f. RICHARD H. GORINa
~ ,
.y. •ti ~ ~ ' ~ `'GG': A :
_ ; ~ ' ~ ~ f fii : = (Address)
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z.ES e. aoaiRa
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1iC r~~~tid subscribsd bafore me this 2 2rld day ~ Jul , .
~
ROGf!
q~ Notary Public ~
` D.C. My Commiuion expit~s
~Y
(T~ M _ i~ d~ical~ ~i ~i~iw~l Ni R whb CM~k Ci~a~if Gw~. a~i drpKal~ wi1M Tax A~?a
~i72 P~2454
t~. 13
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