HomeMy WebLinkAbout1399 Decla~a~tio~ ot Domicil~ a~d Citl:enship
1'76213
TO THE STATE AND COUNTY TAX ASSESSOR. .
Sl. LUCIE GOUNTY, FIORIDA: ~
This is my decia~ation of Domicile and Citizenship in the State of Florida that 1 am filinq this dey in ac~oordanos and
in ao~fwmity with Chepter 222, Section 222.17, Flo~ida . Statutes.
Ash~iile North Carolina
I was fo~me~ly a legal ~esident of
(~ity) (5tats)
and i resided at ~6 poQulsr LaDQ . However I have changsd my domkile
(Street and Numb.::;
• to a~d am and have been a bona fide resident af the State of Floric~a ~inoe 14th day of
I~8rC~1 , 19 69 , and 1 reside at 3921 ~^.yth F1A~*,~
._wt ~ii-xi..
(Street and Number)
FORT r1ERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my dectaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bstablishiag residence
$ntering children i• school
FI~ED ANO RECORO~E~'
ST. LUCIE COUNTYED ~
l~s'~~"~
'69 MAR 28 PM 3: 35
, ~ FOITR~
~ ROCE
~ CLERK CIRCUIT COURT'
I FURTHER CERTIFY that I will aomply with all othe~ requirements of a lepal resident of this State.
~ 1 FURTHER CERTIFY that I have no intention to retum to my fo er domitile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
- i~xe~,~:~,,,,,
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' .s ei . . -
- ~ ~ : s~cn Darrell Lee Capps
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_ ~~A _ - . . : ' (Address)
;''f';jC.,.~..t~9
~!'t~'' 28tb y l~larch
~ Swofn to and subsuibed before me this da of . 19~Q•
ROGER rORRAS
CIRCUIT COURT Notary Public
gy ~ D.C. nny ~ommission expires _
(To b~ ~x~a~t~d in dupUeat~ and oripinal Al~d with q~rlc Graeif Cou~f, and duplieat~ wilb Tax Ats~»vr.)
Mo. 19 ~N~[~~~
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