HomeMy WebLinkAbout1448 Declaration ot Domlcile and Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sj. LU~IE COUNTY, FIORIDA:
This is my dectarotion of Oomicile and Citizenship in the State of Florida that 1 am filin9 this day in aooordanoe and
in oonformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of obLat4~ ~ . R. Z-.
. (Ciy) (State)
and 1 resided at b3 Pine Hiii A~Il~ . However I have chanyed my ciomic3le
(Street and Number) ~
to and am and have been a bona fide residant of the State of Florida sinoe une 6 day of
_ , 19~Q, and I reside at O~ Bn~c 3452
(Sheet and Number) '
FORT PIERCE, SAlNT LUCIE COUNTY, RORIDA
and this stateme~t is to be taken as my declarotion of citizenship, actual legal residence and damicile in ths State of Horida.
(Insert here any pertinent fads, such as sale of property w busineu, or ralinquishment of employment
at former domicile, removal of family b new domicile, purchase of home, etc.)
Bstabiishiag residen~~ FILEO AND RECORDEO
ST. LUCIE COUNTY. FLA. `
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'69 JllN 30 PN 1:OS p
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ti0 "P. :'OITR..S
CLER CIRCUIT COURT
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I RIRTHER ~ERTIFY that I will oomply with all other requiremenri of a lepa) ~esident of this State.
I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. F
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~ (Name) Yirginia neT ;
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~ .l~`.~.S~w,otn ta.a~,tu~u+bed before me this 3Ulb day of June ~q69 ,
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~ , ~'+OQ~R ~O .ITRAS
~ CLERIC CIRCUR COURT Notary Public
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~ By D.C. My ~ommission expires ;
(To b~ ~x~cut~d ~n duplicat~ and ori~nal fibd wkh Cl~elc Gnvi? Courf, and duplicat~ with Tax A~a~aor.)
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