HomeMy WebLinkAbout2286 ~ecla~ation ot Domicile a~d Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FLORIDA: ~
This is my decla~ation of Oomicile and Citizenship in the State of Florida that 1 am filiny this day in aaordanoe and
in conformiy with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a lega) ~esident of Corning N. Y.
(Ciy) (State) .
and I ~esided at - R. D. 3 Gorton Road . However ~ have chan~sd my dom~d~e
(Street and Number)
to and am and have been a bona fide resident of the Stab of Florida sinoe ~TaD. 20 day of
, 19
6~, and I reside at ROUte 4. BOZ 640 -
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, attual lega) residente and domitile in ihe State of Horida.
(Insert here any pertinent fads, such as sale of properiy or business, or relinquishment of employment
at forme~ domicile, removal of family to new domicile, purchase of home, etc.)
Establish residency
FILED ANO RECOROED ~
ST. LUCIE COUNTY. FL/C. .
RFCORD V~RtFlED
1`74'751
'69 FE6 13 A!I II: 7
i~~ . PpITRAS
ROG~
i CLERK CIRCUIT COURT`
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I RIRTHER ~ERTIFY that 1 will oomply with all other raquiremsnts of a(epal resident o~f this State.
I FURTHER CERTIFY that I have no intention to refum to my former domiCile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
? c~- ~
(Name) Lene H rington
~ ~:s`~,,,' ; . ~ - ~ (Address)
. ~ - ~
. Sworh tar:aed.subsuibed before me this 13 day of February , yq~_.
. .
. ` ~f
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tS~1C•~tRCU1T COURT Notary Public
gy D.C. My Commission expires
(To b~ ~c~euf~d in duplicat~ and ori~inal fil~d wi1~ CfKk qrcuM Coue~, and eWplicata wilb Tax Aa~or.)
~i7~
No. 11
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