HomeMy WebLinkAbout0936Declaration of Domicile and Cttlzenship 181,795
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in aotordancs and
in conformiy with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of _ )llart~t west VS rat ni ~
(City) (State)
and I resided at __ x311 IKCCOr>tile Ar! a _ However 1 have changed my domicile
(Street and Number)
ro and am and have been a bona fide resident of the State of Florida since l;gt day of
,duly _~ tq 69 ~ and I reside at 2308 SO 29th stri:tt
(Street and Number)
FORT MERLE, SAINT WCIE COUNTY, RORIDA
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 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.)
Bstablishing residence sad entering child inschool
181'795
FILED ANO RECORDED
ST, IUCIE COUNTY. FLA.
i;CCOR[) VERIr1E~Uj~o , ,,~i/,~
'69 AtfC 13 PH 2 : OS
r.UJEZ POITRhS
CLERK CIRCUIT 000RT-
I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
t FURTHER CERTIFY that I have no intention. to return to my former domirjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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Swom to and subscribed before me this
ROGER F'OITRAS
CIRCU COURT
My Commiuion expires
tTo bo executed in duplicate and original Fled with Ciarlc CirwH Court, and duplir.ats with Tax Assessor.)
eooK 179. ~ 935
13th
(Name)
Woodrow Bvrses
1~ ~~
(Address)
August ~q 69
day of - -
Notary Public
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