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HomeMy WebLinkAbout0294Declaration of Domicile and Citlsenship ' TO THE STATE AND COUNTY TAX ASSESSOR, • 1$,134 Sl. LUCIE COUNTY, FLORIDA: This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and in conformity with Chapter 222, Section 222.17, Florida Statutes. I was formerly a legal resident of NBW Yt~it (City) (State) and I resided at ~ 1S Ela~rlood Awe. _ _. However 1 have changed my domicile (Street and Number) to and am and have been a bona fide resident of the State of Florida since 1S th - dsy of July , 19 b9 , and I reside at 2605 St~ri~ E1r1 - (Street and Number) FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. (Insert here any pertinent fads, such as sale of property .or business, or relinquishment of employment at former domicile, removal of family to new domicile, purchase of home, etc.) C~ITHIA BLIZABSl'fI L30NARD li years of sge GBORGB THOMti3 L~O~IARD III 1S years of age YATHBRINB C,AirtILLB L10NARD 10 years of sge RECORDED E1<.EO ANO AUNTY FLA• S?.~V~~ 0 VERIFIED 151314 9 a~~c ~ pM ~Z : 02 6 ;iO~~R ~0!S COURT CLERK CIRCUIT I RJRTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. I FURTHER CERTIFY that I have no intention to return to my former domicjle, and 1 intend to remain in FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. - . - - _ ~ K/~THBRINB L. ARD ;;rust::; ; "s :,; .., •''' (Name) ~lQt$. GHURCsB T. I~OIIARD) ~:~~, :; ~' - . ; ~J'Q= n •= Z60S St~arise Brad. - •• _ .., . - '''gym: . = (Address) - ~, ~ ~ ~ ~ x: ~ - Pt. Pierce, Pla. 33450 !.i,~~woni•~p~n?l~'subscribed before me this 1st day of ">rta:t , 19~Q_. r~ ROGER POITRAS CLERIC CIRCUIT COURT gy a- O.C. Notary Public My Commission expires (To be executed in dupliuh and ori~nal filed with Clerk Cirwif Court, and duplicate with Tax .) ~. ,~ g~K179 ~ 2~~4