HomeMy WebLinkAbout0594 Dectaration of Domicile and Citizenship ~
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TO THE STATE AND GOUNTY TAX ASSESSOR, ~
Sl. tUC1E COUNTY, FlORIOA; ~
Th~s is my da"arotion of Oomicile and Citizenship in the Ststs of Flwida that 1 am filin~ this day in aooordants and
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~n conformiy with Chapter 222, Section 222.17, Florida Statutea.
1 was formerly a legal resident of _ C'arY Indiana ~ '
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(Ciry) (State)
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and 1 resided at 5400 West 41st Street However 1 have changed my domiGle ~
(Street and Number)
ro and am and have been a bona fide resident of the State of Florida sirxe June 10 day of
, 19 68 , and 1 reside at 1403 ~x~pj[z~l[ 2e~hyr Avenue
(Sfreat artd Number)
FORT PlERCF, SAlNT LUCIE COUNTY, FLORIDA
and this atatement is to be taken as my declaration of citizenship, actual legal residence and domicile in ihe State of Horida.
(Insert here any pe~tinent facis, such as sale of property or business, or ~eltnquishment of employment
at former domicile, removal of family to naw domicile, purchase of home, etc.)
~ - Bntering chiidren in school
FILED AND RECORDED'
S7. l.UC1E COUNT~ ~~~A.
P~O~
'68 AUG 19 PN 2:26
- =~.e:~~:R ~~o~ ~ Rr:s
CLERK CIRCUIT COURT
t FURTHER CERTIFY that I will oomply with all other requirements of a legal'resident of this State.
I FURTHER CERTIFY thar I have no intention to retum to ri~y former domiGle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIUA, permanently.
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(Name) ~S • ba riea Randhan
(Addressj
Sworn to and subsuibed before me this 19th day of AvKus t 19 68
. , .
ROGER POITRAS -
CLERK CIRCUIT COIaRT Notary Public s
BY ~ ~ cl ~l~.C. My Commiuion expitss '
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-(to b. ~x.w+.d .ia.~Ptkar~ and orisi~al fil~d with CIKIc t~rwit Co~~t, a~+d duplica~~ wiM~ Tax Ass.ssora s
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