HomeMy WebLinkAbout0900Declaration of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR: 181'764
51. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in aoaordanoa and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
Post Jefferson
I was formerly a legal resident of
(City)
and 1 resided at _ 47 Laurel Drive
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 8th day of
Port 3t. Lucie
August 159 N1.8. Lobster Road
____ 19 ~ and I reside at
(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 Horida.
(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.)
Bstablishins residence
12th
I FURTHER CERTIFY that 1 will comply with all other requiremenri of s legal resident of this State.
1 FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in FORT
PIERCE; SAIM LUCIE COUNTY, FIORIDA, permanently.
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Sworn to and subscribed before me this
ROGER iPO1TRA5
CIRCUIT OURT
gy ~ D.C.
Notary Public
My Commission expires
(To be executed in duplicate and original Tiled witlh Cleric Circuit Court, and duplicate with Tax Assessor.)
a~K 179 ~ 899
C/V
(Name)
Richard A. Wurat
NeM Yo r1c
(State)
However 1 have changed my domicile
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FILED AND RECORDEp t
ST. LUCIE COUNT
RECORD VERIFYEDFlA;'.
'69 aUG 12 Pp 1
n2G
CLERK ~ RC OtT p, S
UI7 CpURTj~.
(Address)
day of August
19 69.
Ho. 13
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