HomeMy WebLinkAbout0773 O~clat~ation of Domlail~ and Citiz~nship 1~~~~
TO THE STATE AN~ COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FLORIDA:
Thi: i: my dacla~ation of Oomicile and Gitizenship in th~ State of Florida that i am filin~ this d~y in aooordanos end
in conformity with Chapht 222. Section 22Z.17, Floride Statutes.
I was formKly a leqat resident of ~9uOktti Io~a
(Cityj (S~:~s)
end 1~idsd at 20? Au3tio Ave. . t~owwer ~ Mve chanQsd .-y domkile
(Sneet and Numbsr) ,
ro and am and have baan a bona fide resident of ths Staro of Florida since lst ' day of
_july ,~q 68 , a„~ i ~ 3236 W. Lake Drive
(5trset snd Number)
FORT MEtCE, SAM1T LUC~ COUNTY, RORI~A
and this :tatement is to be taken as my dedaration of dtizenship, actual legal residenoe and domicile in ths Stsro of Horida.
qnsert hero amr pertinent facts, such as aale of properry or business, or relinquiahment of employment
at ~mer domicile, removal of family ro new domiale, purchase of home, etc.)
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'69 ~A 0 ~ ~
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1 FURTHER CHtTIFY fhat 1 w111 oompiy witfi all otF~ rsquireir~nfs .of ~ lepal rosident of fhis State.
I fURTHER CERTIFY that 1 have no intention to retum to my domitil and 1 intend to ~emsin in FORT _
PIEt~CE, SAINT IUCIE COUNTY, FLORIDA, permsnently.
' . r~ .
~ ~ ~ , • a % RALPH W. BBNSUN ;
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~ , ~ : ~ • ~ 3235 W. Lake Drive ~
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b~nd wbstribed bsfon me_thi: day of ~januar~ , 19~4
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ROO~R lOITRAt ~
CIRGNT COYRT _ Notary Publk
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8y • A'~'~ D.C. My Gonxnission txpirss
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