HomeMy WebLinkAbout1576 Declaratlon ot Domicile and Citise~ship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORI~A: ,
This is my declaration of Domicile and Citizenship in the State of Florids that 1 am filinq this day in aooordanu and
in oonformity with Chapter 222, Section 222.17, Florida Statutes.
I wat formerly a Iaqal ~esident of College Park Maryland
(City) (State)
and 1 rosided at 8 Rose Lane . Howevar 1 have charpsd my domic3le
{Strest and Number)
ro and am and have been a bona fide ~esident of the State of Florida since st day of
August 68 418 Oleander Ave. ( River Park )
, 19 , and I reside at
(Street and Number)
~ neec~. s~u~ tuc~ cou~rnr, ao~w
and this statement is to ba taken as my declaration of cititenship, actual legal residenae and domitile in theState of Florida.
pnsen here any pertinent facts, such as sale of property or business, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establishin~ residence
F~~~~ AND RECOROEp~
ST.RECO~RQ {~jERIFY' FIA.
1~42ss
~9 JAN 29 p .
' ' S3
c~ ~oc~
ERK ~OITRq~
CUIT COURT
1 FURTHER CfRTIFY that 1 will comply with all other requiremenh of a lspal resident of this Stste.
;
I fURTHER CERTIFY that I have no intention to retum to my former domicjle, and 1 inbnd to remain in FORT
PIERCE, SAlrlj:l~UC,{F;COUNTY, FLORIDA, permanently.
.
• ' , • ••1 ~ ,~~j f / ^ ~ I '
3 f- • ~ ~ , ~ • .
~~1 ~ ~ame~
~ ` ' William H. Grif f ith
c, ' " . . - ~ -
- ~ -
_ ' ~ -
- - •~y (Address)
vi•„ ~
Sworn.to and subsuibsd befor~ me thi: 29th deY ~ Janusiy ~ ~q 69
ROOE~ rO1TRAS
CIR~I~IT Notsry Public
d.~~.,G .
er . o.c. Mr c«~„~u~+ .x~r~
a. r..oo.wh~ iw ~lic.~. .ur .eioM.i Al~i wflh a.~ cfrarM c.w+. «~d ~iic.~. whb Tavc A....«i.a
a~ 175 ~ 15?3
= r _ _ - . - ~
~~:~~..e_ .rs.~~