HomeMy WebLinkAbout2205Oeclaratioln of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. lUC1E 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.
I was formerly a legal resident of Nahunta
(City)
Georgia
(State)
P. 0. Boa 33
and 1 resided at _ _ _. However 1 have changed my domicle
(Street and Number)
b and sm and have been a bona fide resident of the Stab of Florida since August 13 day of
c/o A. Warner
19 69 , and I reside at Rt 1 ~ BOZ 19
FORT PIERCE, SAINNT LUCIE COUNTY, FLORIDA
(Street and Number)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the Stab of Florida.
(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.)
Establishing residency
RECORDED
FILED AN COUNTY. FLA•
ST.~UC~ 1? ~,,FR1=l~D
18264
P 3 : 19
'69 SEp 5 N ~
y`~r^ ITRt~S
.-n
R[) . ~-
CLERK CIRCUIT COUR
I FURTHER CERTIFY that 1 will comply with all other requirements of a lapel resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~1~ ~ •. s
to ands
-~
r~,_.
r
vblgibed .before me this 5
,,
ame) Jan a &~Sckland
s7 }~
(Address)
day of September
l9 6 9
'='~~;' ~~OURT Notary Public
eft + its
gy ~ D.C. My Commission expires
(Te be executed in duplicate and original filed with Cleric Circuiit Court, and dupliiub with Tax Astesaor.)
No. 13 ~ ~