HomeMy WebLinkAbout0911 J,
Oeciaration ot Domicile and Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. UJCIE COUNTY, FLORIDA:
This is my declaration of Oomicile and Citize~ship in the State of Flo~ida that 1 am filing this day in aaoordance and
in aonformity with Chapte~ 222, Saction 222.17, Florida Statutes.
Laural Md• ~
1 waa formerly a legal ~esident ~f
(City) (~!ate)
Bo= 221 Rt. 2
and 1 rosided at . However I have changed my domiqle
(Sireet and Number)
to and am and have been a bona fide ~esident of the State of Florida since AuB~st day of
, 19 68 , and I reside at Rt. 1. BOZ ?50 ,
(Street and Number) '
FORT MQCE, SAlNT LUCIE COUNTY, FLORIGA
and this statem4nt is to be taken as my declaration of citizenship, actual legal ~esidenoe and domicile in the State of Horida. ~
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qnse~t here any pertinent facts, such as sale of property or business, or relinquishment of employment ~
at former domicile, remova) of family to new domicile, purchase of home, etc.)
,
FILEp qNp RECORDED '
homegtead purposee ST ~~~~E COUNTy. '
f~~~~RD V['R~FrEG~A. '
~ '69 ~ 1~~4
a~ y ~y ~ ~ , ss
~ R~G~~OtTR
~ - ~ERK C?RCUIT COURT '
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1 RJRTHER CERTIFY that I will oomply with all other requiremenri of a leyal reside~t of this State. ~
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1 fURTHER CERTIFY that 1 have no intention to retum to my former domitile, and 1 intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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. ~ , (Name) -HBrold I,. Andereon
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~ . (Addres:)
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SMwrn.to and subsuibed before me this 14th day of January ~ ~q 69
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ROG~ rO1TRA: ~
C~K WT COURT Notary Public ~
Br ~ D.C. My Commi=sion expires
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R~ M~anaMwl iw d~Wca1~ a~+d ~iaal fil~d wi1l~ CI«k Cb~crit Covr1, snd dvplicat~ wNh Tax Ass«~.) ~
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