HomeMy WebLinkAbout2319 Decla~ation ot Domi~ile and Citizanship 1~4~b~
TO THE STATE ANO COUNTY TAX ASSESSOR, '
Sl. LUCIE COUNTY, FIORIDA:
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This is my declaration of Domicile and Citize~ship in ths State of Florida that 1 am filing this day in aoco~danoe and
in conformiy with Chapter 222, Section 222.17, Flo~ida Statutes.
I was formerly a lega) resident of Pleasantville New York
(CitY) (State) ~
,
and 1 resided at _ 55 plee88?11t Avenue _~V1eVer ~ have changed my domicile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since December 31 day of
, 19
68, and I reside at 109 SODeto COU7ct •
(Street and Number)
fORT PIERCE, SIIINT LUCIE COUNTY, FLOltIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domitile in the State of Ho~ida.
(Insert here any perti~ent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purthase of home, ett.)
for homestead purposes
FILE~ E ~OUN~YOFLI~' ;
gT.1.UC VER1FtE0 t
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~O~Ep 01?R~S
CLERK CIRCUIT COURT'
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I FURTHER ~ERTIFY that I will oomply with all other requimments of a le~al ~esident of this State. ~
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1 FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and 1 intend to remain in FORT ;
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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` ~ ~ 13 February 69
~ ~,S~or?~~ bnd'subsuibed before me this day of , 19 .
ROGER POtTRAS
CLERK CIRCUIT COURT Notary Public
By D.C. My Commiuion expires
(To b~ uacut~d in duplicate and ori~inal fil~d wifb Cl~rk Cira~it Couh, and duplica» wifh Tax AsMS~or.)
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