HomeMy WebLinkAbout2648 Decisration ot Domicile and Citize~sl~ip -169C~85
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E ~OUNTY, FLORIDA:
This is my decla~ation of Uomicile and Citizenship in the State of Florida that 1 am fii~~~y ~:::s ~ay in aao~dance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of SYOSSET _ N• Y• _
(City) (State)
and 1 resided at 57 ~~i tney Ave . However I have changed my domicile
(Slreet and Number)
to and am and have been a bona fide ~esident of the State of Florida since 19t day of
Jul~_ ,~q
68, and I reside at 1604 Seswsy I~. _ _
- (Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORiDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Filing to Establish legal residence ~
FILED AND RECORDED
ST. ~UCIE COUNTY, FLA.
R~ {:Rf~~ :'F;.?F~~r~
~~a7~K7a) .
; '68 Jtll 25 P~ 3:29
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i i:~~;;~?; ='OiTR.:S
f CLERK CIRCUIT COURT
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1 FURTHER CERTIFlf that I will oomply with all other requirements of a lega) resident of thia State.
1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
(Name)
~ ,,,,,,?~::,~,r,,,, CI,AY GAR.RETT
~ 1~5` .
r 1 3
i'~ J ~ ^ ~~/i
(Address)
- •~i`' a. L•
- ' _ : • ~ ~ • " =
. - 68
~ SwQrn,to"~~d stibsuibed before me this ~5 day of July ,~q ,
' :
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. G~ ' 1~0~
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'•~t~R1! RC T OURT Notary Public
.
gy D.C. My Commission expires
(To b~ ~x m duplicat~ and ori~inal ~il~d w~tb Cl~rlc Circuit Court, snd duplicat~ with Tax Ass~stor.)
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