HomeMy WebLinkAbout0669 Declaration ot Domicile and Citize~ship -16~72
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TO THE STATE AN~ COUNTY TAX ASSESSOR, ~ - t
Sl, lUC1E COUNTY. FlORIOA: -
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This is my detlarotion of ~omicile and Citizenship in the State of Florida that I am filiny this day in eaoo~dante and
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in conformity with Chapter 222, Section 222.17, Flotida Statutes.
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I was formerly a legal resident of giA DeJaneria .~BSi~ • ~
~C;~y~ (State)
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and 1 resided at _ Gellerg.l UrQlii~B 223 - However 1 have chsnqed my domic,ile
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Florida since l9th day of
~u~~st , i9.b8_, and ~ ~eside at Salerno 8oad Lilyan Parkway Boz
(Street and Number) $t ~ 2
FORT PIERCE, SAINT LUCIE COUNTY, FLORIOA
and this statement is to be taken as my declarotion of citizenship, actual legal residence and domicile in the State of Hotida.
(Insert here any pe~ti~ent facts, such as sale of property or business, or relinquishment of employment
at former domic3le, removal of family to new domicile, purchase of home, etc.)
~ Sntering ohildren in sohool
Gary Gilmore ~
Saott Gilmore .
FILEO QND RECOROED ~ ~
' ST. LUCIE COUNTY, FLA:: ~
~~~~~~~21FIED '
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~ '68 AUG 2 0 PM 3: I 8
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~ !',OC ~R i'017RAS
~ CLERK CIRCUIT COURT
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1 FURTHER CERTIFY that I will aomply with all other requirements of a legaf'resident of this State.
I FURTHER CERTIFY that 1 have no intention to ~etum to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. . -
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~ (Name JohII P. Qrllmore
~ . : alerno ad. Lilyan parkway
- - , Bo= 377950 Houte 2
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~ 3'vVbrn to and subscribed before me this 2.~Lh day of ~~•p»Rt , 19.b8_.
ROGER POITRAS '
C~ERK CIRCUIT COURT Notary Public
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g~ ~ D.G. My Commiuion expires ~
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(To be executed in dupticat~ and original filed with C~~rcuit Couet, snd duplicat~ with Tax Ass~sso?.)
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