HomeMy WebLinkAbout0702 Decla~ation ot Domicile a~~ Citi:enship
TO THE STATE AND COUNTY TAX A?SStSSOR,
51. lUC1E COUNTY; FIORIDA:
Thii is my declaratior? of Domicile and Citizenship in the State af Florid~ that I am filinp this day in eooordana and
in co~formity with Chapter 222, Section 22Z.17, Florida Statutes.
I wai forme~ly a leqal rosidant of Chica~o Illineis
(~ity) (SfsM)
~ and I rosidsd •t Sa43 No.Yiaball AveOUe ~ ~
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(Sheet and Numb~~)
' to a~d am and haw been a bona fic{~ ros~dsnt of th~ Stat~ ~ Florida ~ina ~rCh 18 ~y ~
c% Sumes $ es~an
t9~, .nd ~~ids at Pt. Pierce~ Piorida
(Street and Numbsr)
; FOR? PtERCE, SAINT LUCIE COUNTY, FLORIDA
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and this statement is ro be taken as my dedantfon of citiunship, actual Ia~al residenoe and domicil~ in ths Statt of Florida.
. pnsert here any pertinsnt fads. such ~ sa{e of propsrty or businsu, or mlinqui~rr~t of irnp{aym~nt ~
;
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~ ~t fomne~ domidle. ~smoval of family ~o new domicil~, purchas~ of harw, NcJ
Por reaidene~ aad homeatead purposes
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f I~E~ AND REC~R~ED .
C~V fL
~TY. F.
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I RIRTHER GERTIFY that 1 will oompiy wNh all other ~~quirement= of a Ipal r~ident of thi~ State.
! I FURTHER CERTIFY that I have no intention to ~etum to my former domicile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently. ~
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'ai~d subsuibed before ms this 18 _ ~y ~ liarch ' lq 69
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ROGER POIYRAS
~ CLERK GRCUR COURT Notary Public
6y D.C. My Commis~o~? expi~~s
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Ro b~ ~x~cvhd ia d~plicat~ aed ori~in~l fil~d witl~ C{~k Cinarit Covrt, apd dvplicaM wfM~ Tax A~sKa
gooK 17~ 701 ~
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