HomeMy WebLinkAbout0813Declaration of Domicile and Citizenship
181691
TO THE STATE ANO COUNTY TAX ASSESSOR,
Sl, lUC1E COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of $~ ~ ~idC!)r N~tir Ycs r~
(City) (State)
and I resided at - 1695 Rarbari Lane _. However 1 have changed my domiale j
(Street and Number) (~
1
a
ro and am and have been a bona fide resident of the State of Florida since ~~ day of }
-July 19 69 19T SS. Jsrds3n Rd. Post St. Lucie
,and !reside at
(Street and Number) ,
FORT PIERCE, SAINT LUCIE COUNTY, RORI~A
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 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.)
(Ho>•estesd exeaption)
FILED AND RECORDEO~
ST, LUCIE COUNTY, FLA.
R%CORp VERtFIEpB
,sg -(( 1691
AUG t I PN 2 ; 43
RODE? ~•OITR,;S
CLERK CIRCUIT COURT
I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
FURTHER CERTIFY that I have no intention to return to my former domivle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
. _ ,~~ -..
,y: •~ •' ~ ( dress)
., ,~ _:
--~ • :•v
Q) g S~rBM.:rD and subscribed before me this 1 ~ *~-- day of x ~~ sNit ~ -69-•
' ~ .
,~
IiocEle PomlAs
C16tCU1T COURT Notary Public
gy D.C. My Commission expires
(To bo executed in duplicate and original f~le~! ,,Cleric gnuit Court, and drrpliea» with Tax .)
doox ~. ry ~ 8
tdo. 13
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