HomeMy WebLinkAbout1256Declaration of Domicile and Citizelnship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domieile 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 DUrb~
(City)
and 1 resided at . 124 Andrext3 Road
(Street and Number)
ro and am and have been a bona fide resident of the State of Florida since
N.C..
(State)
_. However 1 have changed my domicile
June S day of
199 , and I reside at ~ Tbrif tv Mntel 3602 ~. Pgd _ H~rgt
(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 Fbrida.
(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.)
Larry Lee, Roger Dale,Bryce Byerly
FI<.EO AND RECORDED
ST. LUCIE COUNTY. is t_A.
Rc;~pti`1 V£R1riE0
182a .~
~9 PM ~. 22
69 AtlC Q~
i~?~
+10UtR t' Rf',S
CLERK CIRCUIT COURT
I FURTHER 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 domicile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
(Name) Mary Ros iIIe
,; . _ Byerly
_,- _,
'~ - . - • ..~ (Address)
~• '~
`' -
.i• :_r~tq-mod subscribed before me this 19 day of Au~uBt 19~_.
r' ,
'F Fti~
ti n ij
ROGER POITRAS
CLERK CIRCUR COURT Notary Public
gy D.C. My Commission expires -
(To be etcecuhd in duplicate and original filed with Clerk Circuit Court, arw! duplicate with Tax Assesaora
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do K179 X1255
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