HomeMy WebLinkAbout0234 -L'~3~360
D~cluatlon ot Domicil~ and Citis~nship
TO THE STATE IWD COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FlOR10A:
This i: my declaration of Domicile and Citir~nihip in th~ State o# Florida that 1 am filin~ this day in acoordana ~d
in aonformily with Chapro? 222, Section 222.17, Flortda Ststutes.
I w~s formsrly a Ipal rosident of Somerset Pennsylvania _
(City) (Stab)
and 1~idsd at Rd #1 ChampioD , Pa. my ~~1e
(Street amd Numbsr)
ro and am ar+d have been a bona fide rosident of the Stste of Florida sinoe lat ~y
October ,~q 68~ a~ ~ 149 Ramie Lane, River park
_ (Streef and Number)
!'ORT MERC~. SAINT IUCI! COUNTY, l~ORlDA ~
and this ststement is b bs taksn as my dedaratio~ of citinenship, acfual lepal res'~denoe and domidle i~ 1M Stete of flor~idi.
q~ert hsre any pertinent facts, such as sale of properry or business, or rolinqui~ment of employmsnt
at former domidle, renwval of family to new domicile, purchase of home, etc.) '
St~~ CJE ~uNCORpQ01
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I FURTHER {~RTIFY that I will aomply witfi ail o~thsr nquirem~nts aF a lepal rssident of this State.
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I FURTHER CERTIFY that i have no intention b retum to my former domiGle, and 1 intend to remain in FORT ~
PIERCE, SAINT U1CIE ~OUNTIf, FLORIDA, permanently. 1 ~
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_ . PRANCIS SAUNDBRS ~
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€ _ , 149 Ramie Lane, River Park
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' S~i~p~S.ra•s~i~~ubsaribsd before me thi: 31 st ~Y ~ December 19 68.
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Ct~RK Cl~WR COtIRT Notary Pubiic
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By ~ D.C. My Commission expires
a. b. .a~.a~.a M d~p~c~. .~a e~ar ~I.a ,ai~l~ a.ek cie~a~M c~, .~a a~. T.x w.....Ka
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