HomeMy WebLinkAbout0968 Decla~~tion ot Domicile and CHixenship
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TO THE STATE AND COUNTY TAX ASSESSOR, _
Sl. IUCIE COUNTY, FLORIDA:
This is my dectarotion of Onmicile and Citizenship in the State of Florida that 1 am fitin~ this day in eooordanos and
in oonformity with Chapter 222, Section 224.17, florida Statutes.
I was fo~me~ly a legal resident of P1ee~rt Loog Isiaad NCM YOrt ~
~~ity) (Stat~)
and 1 resided at 116 Wlst I~tt~Ct . Howevef I have changed my domidle
(Sheet and Number);
to and am and have been a bona fide resident of the State of Florida since 31st dsy of
Msrch , 19 69 and 1 ~es~de at ~9 Garden Ave.
(Street and Number)
FORT M~CE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pe~tinent fads, such as sale of p~operty or busineu, or relinquishment of employment
at forme~ domicile, removal of family to new domicile, purchase of home, ett.)
Batsbiishing reaidence
FIlEO AND RECORO~D
ST. LUCIE COUNTY. Fl,q,
r' ~O~D VFRlFIED
1~''~90
'~9 JUt~ 2 0 PM 2: f Z
i ROt,~rZ POITRAS~
' ~~FRK ~~RC~~T COURT
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I FURTHER GEttTIFY that 1 will oomply with all other roquiremenb of a leyal r~ident of thi: Stste.
I FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COt1NTY, FLORIDA, permanently.
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-~`~~~~rwn` ta and subscribed before me this day of . , -
ROG~ rOIi~AS ~
~~R Notary Public
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~ gy D.C. My ~ommission expires
(T~ b~ uaaNd ie duplic~h and oridnal fii~d w~b Cl~ek qrwif Couet. and duplicat~ wNl~ Tax At~o~a
PooK 1?8 ~,~F 967
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