HomeMy WebLinkAbout1488Declaration of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in sooordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of ROChester New YOrY
(City) (State)
1107 Five Mile I.3ne Road -Webster
and 1 resided at - _ _-___-. However 1 have changed my domicile
(Street aril Number)
to and am and have been a bona fide resident of the State of Florida since Aug 22 day of
_ 19 69 and I reside at 1339 Seaway Drive _
(Street and Number)
FORT PIERCE, SAINT LUCIE 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.)
Rhonda Gertner
1
FILED AND RECORDED
ST. LUCIE COUNTY, FLA.
t~r-CnF7 vERI-=t~D
1821'7
'69 !:U'' 2 5 AN 1: 5 9
6
CLERK CIRCUIT COURT
I FURTHER CEfiTIFY 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 domicjte, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
/ ~/i~i,,, D ~~~irrtir~
~•.~~T''''''~~++'''' (Name) Roxanne Gertner
(Address)
Sworg1M'bnd subscribed before me this 25th day of Au~u3t ~ Iq 69
,..
~.;~ ...
_ ROOEit P4iTitAS
Clil;llK CIRC~T ~COU Notary Public
,,
ey '• ' ~ D.C. My Commission expires
~.~ .•..
z 0•.
(To ibe iiceeutad in duplicate and ori~nal filed with Cleric Cirwit Court, and dupliu» with Tax Assessor.)
sooK~.?9 ~~.487 ao t r _j
ko. 13
a
~x -s~~ - ___ 'P ~ ;
- _~