HomeMy WebLinkAbout1291Declaratioln of Domicile and Citlsenship
TO THE STATE ANO COUNTY TAX ASSESSOR, 18205'7
Sl. IUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of Beldcr Colaradr3
(City) (State)
and 1 resided at X1,5 ltal~~y VieM Drire However 1 have changed my domicjle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 12th day of
An~+ryt 19S1Q., and I reside at ~~$2 Midway Road
(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 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.)
Establish residence ~ ~ -
Entering child in school.
FILEO ANU REEOR~ A~.'
ST~RECORD VER~EO
0523
• 2~
69 QUG
ROC,Ep POITRAS
CLERK CIRCUIT COURT:
1 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 domicile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
(Name) Williald H. Richards
(Bill)
(Address)
Sworn to and subscribed before me this ?.4.th day of Au¢ust 19 64.
.. ....,Li. t
ROGER. pO3i16AS~ .'~ ;
CLERK" COURT''~~: Notary Public
.rr~
" ~ ~.. --
gy ~ D.C. My Commission expires
~.
(To Ilse etis 'eulyd'Ni.~d~iMlicate and original filed with Clalc Circuit Court, and dupliuh with Tax AssaaorJ
gooK~79 ~~1~~
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No. ! 3