HomeMy WebLinkAbout2463Declaration of Domicile and Citizenship
TO THE STATE ANO COUNTY TAX ASSESSOR, -~~~y892
ST. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and ~ tizenship in the State of Florida that 1 am filirg this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of ~; 4+at,r.r.+ _131L1;.aTla
' ~ (City) (State)
and 1 resided at Rt 1 Hov-'ever 1 have charged my domidk
(Street and Number)
b and ~am and have been a bona fide resident of the State of Florida since -• day of
SeTt , 19___6.2, and I reside at 1607 Citrus A~~nu~
(Street and Number)
FORT , SAINT LI,ICIE COUNTY, RORIDA
and this statement is b be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family b new domicile, purchase of home, etc.)
fiatabliah Residency
ST,~ CIE COUNTY 0~0'
RFCORp bERIFIEp~A'
'69 SEP ~ 182892
PM 2:02
ROGER P~i~
CLERK CIRCUIT ~~
OIIRTj
1 FURTHER CERTIFY that I will comply with all other. requirements of a bpal resident of this State.
t FURTHER CERTIFY that I have no intention b return to my former domicGle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
'
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O.C.
Notary Public
My Commission expires
(fo be exearhd in duplicate and original filed with Clerk Cirarit Court, and duplicato wish Tax Asaeaor.)
~. ,~
GEC-c~o~'L, G~ SC%
(h1an~) Leota entry
(Address)
subscribed before me this > > tl+ day of ~ tei tpmber , 191>4_.
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couRT
eooK179 ~~~2461