HomeMy WebLinkAbout1461 Declaration ot Domicile a~d Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, Q('~ ty
Y,O~~ I
Si. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida thst 1 am filiny this day in aooordance and
in conformity with Chapter 222, Section 222.17. Florida Statutes.
I was formerly a legal resident of -~~~fieid Ob~O
. (CitY) (State)
and I resided at - 3'~ Sturges A~e However 1 have cfianged my domiCile
(Street and Number)
to and am and have been a bona fide resident of the State of Florids since 14th day of
~t• , 19 68 and I reside at 38Z1 PoCatello
(St~eet and Number)
fORT PIEItCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the Stste of Ho~ida.
(Inscrt here any pe~tinent facts, such as sale of property or busineu, o~ relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bstablishing residence
ftLED ANp F~ECORDEp
- `'7• LU~l~ ~t}U;:TY, F~
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CLERi~ ~~PCU,7 COURT
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~ 1 FURTHER CERTIfY that 1 will comply with all other requiremenb of a IeQal resident of this State.
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~ 1 FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in FORT
PIERCE, SAINT IUCIE COUNTY, FIORIDA, permanently_
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~ - ~j''= R. P. Scott, ll
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~ ~ ~ ~ Bnid V, S~ott,
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~ ~worato~s~~suburibed before me this 3Uth day of Junc 19.~Q..
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~ CIRC OURT Notary Public
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8 D.C. My Commission expires
Re b~ ~x~cuhd ie dupticah and ori~nal fil~d whl~ Cl~ek Cirarit Cou~, and dupliut~ wi~h Tax As~to~.)
~ aoa~ ~78 1460
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