HomeMy WebLinkAbout2489De~la~ation of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
S1. 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 22?, Section ?22.17, Florida Statutes.
1 was formerly a legal resident of Sayllille
(City)
and 1 resided at 16 M Street
(Street and Number)
Hew Yo rlt
(Stab)
However 1 have changed my domicile
ro and am and have been a bona fide resident of the Stab of Florida since Sept • 1 -day of
19~-, and 1 reside at 173 Soneto Court _
(Street aril Number)
FORT tiERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residerxe and domicile in the Stab of Horida.
pnsert 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.)
Placing ~iidren in public school
Robert, Stephen and Diane Berg
FILED AND RECORDED
ST. LUCIE COUNTY, FLA.
~~=COR~ VERIFI;D
182913
'fig SEP 12 ~M 10:34
c
I:O~cR ~ R:.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 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~~/'
(Name) R. C. HOtrren
(Address)
before me this ~ day of Sept • ~ 19 69
Notary Public
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D.C. My Commission expires
By
(To be exearted in dupliuh and ori~nal filed wiflr Clerk Cirwit Court, and duplieah wi11r Tax Asaaaor.)
No. 13
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5-~.
~K 179 r~E2487