HomeMy WebLinkAbout0864 ~ D~claration ot Domicli~ and Citis~nship ~~3~4
TO THE STATE AN~ COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FIORIDA:
Thli is my declaration of Domicile a~d Citii,enship i~ the State of Florida that I sm filin~ this day in aooorda~ and
in oonformity with Chapter 222. Settion 222.1~, Florida Statutes. -
i was ~rner~ a I Binghae~ton ~;cx~; New York
y pal msident of
(City) (Stat~)
and 1 rosidsd at Ir! R 95 Sh~pma~ Road . Howevar i have charqsd my domkik
(Street and Number)
to and am end have bsen a bona fide rosident of the State of Florida since December 21 day oi
, t9 68 , and i~ide a~ 1923 Wyoming Avenue -
(Street and Number)
ro~r ne~, s~ w~ couNnr, ao~w
and this statement is to be taken ss my declaration of citizer?ship, actuai legal res'~denoe and domiale in the State of Horida.
(Insert hsre any pertinent facts, such as sale of propeNy or business, or relinquishment of employment
at former domicile, mmoval of family to new domidle, purchase of home, etc.)
Children entering pubiic sEhooi
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,69 SAN G~?
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R~G CIRCV~T C~v
s C1.ERK ~
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I FURTHER GHtTiFY that I wlll aomply with all other roquiromsnh of a le~al residsnt of this State.
I FURTHER CERTIFY that 1 have no intention to retum to my former domitile, and I intend to remain in FORT
0l~,~~iN'f WCIE COUNTY, FLORIDA, permanently.
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~ ~ = , (Name) Robert R. Riimer ~
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~ , . .
. : (~4~ddress)
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Swotn ro and wbsuibsd before ms this day of . 19 . ~
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ROOtR rOiTRAt
CLiRK CIRCINT O011RT Not~ry Public ~
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R. w.oo.a~i r~kM. aai «i~wal A~i will~ a«~C ci~f c.w~, wi~ T.ac A...»..a ~
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