HomeMy WebLinkAbout1748 Declaratlon ot Domicile ~nd Cittzenship 1'744U6 ~
TO THE STATE AND COUNTY TAX ASSESSOR. ~
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Sl. IUCIE COUNTY, FIORIDA:
This is my declaration ~f Uomicile and Citizenship in the State of Florida that I am filing this day in aaordanoe and
in conformity with Chapter 222, Sectio~ 222.17, Florida Statutes. E
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I was formerly a legal resident of Newbery Port Mac_c~
(City) (Stete) ;
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and 1 resided at _ K Stre@t _ . However 1 have changed my domidle
~ (Street and Number) ;
to and am a~d have been a bona fide resident of the State of Florida si~ce 27th day of
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December , ~q 68, a~ I reside at No. Old Di~ciP Hwy.
(Sheet and Number)
FORT PIEftCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residente and domicile in the State of Ho~ida.
(Insert here any pe~tinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
FILED A~10 RECORDED ~
ST. LUCIE COUNTY. FL,d.
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'fis FFB 3 ,aM io : o
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Ho~~~ ~6~TRas
CLERK CIRCUIT COURT
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I FURTHER CERTIFY that I will comply with all other requiremenis of a legal resident of thia State.
I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT ;
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PIERCE, SAtt~T_~KIE COUNTY, FLORIDA, permanently. ~
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- '-'~~''f,, DONHI.D G . BRBWBR ~
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, . ~ ' „ = (Name)
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- A•• .,~~R:~Y'-~ .a/ ~ ' . .
~ l•~'' "j`~`'*~~~~ j• - No. Old Dixie Hwy. Ft. Pierce
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~~ivifrii~fo and subscribed before me this 3re day of F ARL~ARY , 1q~iQ- {
ROGER PORRAS
~LERK CIRCUIT COURT Notary Public
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gy .C. My Commission expires
(To b~ ~x~cut~d in dupliah snd ori~inal fila! with q~rlc Circuit Cour1, snd dupficat~ with Tax A~stor.)
„ a~~ 175 ~:1~45
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