HomeMy WebLinkAbout2216 Decl~ration ot Domicile a~d Citizen~hip
17'469~
TO TH~ STATE AND COUNTY TAX ASSESSOR,
Si. LUCIE ~OUNTY, FIORIDA:
This is my decla~ation of Domicile and Citizenship in ths State of Florida that 1 am filing this day in acoorda~os and
in oonfo~mity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of Ce n t e rvi 11e , Md.
(C;ty) (State)
Chesterf ield Avenue
and 1 resided at . Fbwever 1 have changed my domidie
(Street and Number)
to and am and have been a bona fide resident of the Stab of Florida since Jan. 9 day of
_ , t9 69 , and I reside at 721 So. 2nd Street
. (Street and Number)
FORT PIERCE, SAINT IIKIE COUNTY, RORIDA r'
and this statement is to be taken as my deciarotion of citizenship, actuai legal ~esidence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or busineu, or relinquishment of emptoyment
at former domicile, remova) of family to new domicile, purchase of home, etc.)
Entering childfen in public schools
Wayne and Connie Lynn Scott
FILEO AND RECORDED
ST.~U
egn ~E~Tr EOL~~
i'74699
'fi9 fEB ~ 2~ 9' y0
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.~%cG~ TRAS
~ ~Ov...R
CLERK CIR UIT COURT
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I FURTHER CERTIFY that I will oomply with all other requirements of a lepal resident of this State.
1 FURTHER CERTIFY that I have no intention to retum to my former domi~jle, and 1 inTend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. t ~
~',I~'~
(Name) Irvin Scott
. (Address)
~ Sworn to .e ~i~i, s~bsuibed before me this, 12 day of J at] U aiy ~ 9 6 9.
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~ • ' . ROGER•,~OITRAS
% ,~LL~RIC'.tlittUR COURT Notary Public
. ~ ~
g - ~ ~ " D.C. My Commiss'wn expires
(To b~ ~x~cuted in duplicah and oripinal Rl~d witb Cl~k U~N Coue1, and duplicah with Tax Aaatoa)
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