HomeMy WebLinkAbout0776DeCla~ation of Domicile and Citizenship 181665
TO THE STATE AND COUNTY TAX ASSESSOR,
Si. tUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in scoordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of GR.88NWI~ ~~
(City) (Sta»)
and I resided at 68 Meat BtOther Dr3~e However 1 have changed my domidle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since. 1Sth T.1lC eY ~
Port st.
Jaly , tq 69 , and I reside at 611 Ash S~=tet.e Pt Pierces Fla~__
(Street and Number)
FORT r1ERCE, SAINT LUCtE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the Sta» of Honda.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
FILED AND RECORDED
ST, LUCIE COUNTY, FLA.
ItECORD b'~RIFtEU
181665
'69 AtlL I I AN 10:53
•~ic
hO~E~ r•OITRA
CLERK CIRCUIT COURT
I FURTHER CERTIFY that 1 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 I intend to remain in FORT
PIERCE, SAINT~LUC~E•~OUNTY,~FLORIDA, permanently.
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s-~~, =',_ ~ ; _; . y ame port Ssint Lucie
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- -'~= ~'~`~ ~ bai Ash Street, Ft. pierce, Pise
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ibed before me this 11 day of
ub
~; ~ ~~'~ito
i~ Au>xust , 194..
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ROfiER 'OITRAS
CIRCUR COURT Notary Public
'S~ D
C ires
Commission ex
M
gy
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y
(Te be execu»d fn dvplica» and original Bled with Clerk gnwh Court, and duptiuN with Tax Asas~.) ~
0 R 1'1'9 PACE ~75 - __. ,
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