HomeMy WebLinkAbout2477 Declaration ot Domicile and Citisenship ~
TO THE STATE AND COUNTY TAX ASSESSOR,
S~. lUC1E COUNTY, FIORIDA:
This is my dacla~ation of Domicile and Citizenship in the State of Florida that 1 am filinq this day i~ acoordanoe and
in oonformity with Chapte~ 222, Section 422.17, Flo~ida Statutes.
1 was formerly a legal ~esident o~'r~el~Ort - I11•
(City) (Stah)
and 1 resided at 1026 S St~cbp Stselt , However I have chan~ed my domk3l~
(Street and Number)
ro and am and have been a bona fide resident of the State of Florida since lst daY of
1406 De1.A~e.
April ~ ~q 69, and I reside at ~
, (Street and Number)
FORT ~CE, SAINT LUCIE COUNTY, RORIOA
and this statement is to be taken as my declaration of citizenship, actual Icgal residenoe and domiale in the State of Horida.
(Insert here any pertinent facts, such as sale of property or busineu, or relinquishment of employment
at former domicile, removal of family to new domicile, purthase of home, efc.)
Bntering Cynthis in the 2nd grsde
1'7'7'03~
FILEO ANO RECOROED
ST. LUCIE COUNTY, FLA:
:~iECORt? t~FRIF~ED
'69 APR I 6 PM i: 5 i
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RQ ~ t rt r'OiTtilrS
CLERK CIRCUIT COURT
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I RJRTHER GfftTIFY that 1 will oomply with all other rsquirements of a le~al rssident of this State.
I FURTHER CFRTIFY that I have no intention to retum to my forme~ domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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>>"'~?~''~"t'r C YY
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~ : ;r ' (Plame)
~ .~s,,.;lr~";: C4r~en Russell
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, C t ~ , 69
SwpR to and subxribed before me this 16 th . day of Apr i 1 ~ 9 .
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RO~ POITRAS `
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C COtIRT Notary Pubiic t
p~~d:-~E,cl~ ~
~ By D.C. My Gommiuion sxpires
(T~ b~ ~x~w1~d iw duplical~ and Nioiw~l f~ wilb Ci~ei~ CkcYit Gwt, awd d~lial~ will~ Tax A~era
~i'~ ~24?4
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