HomeMy WebLinkAbout2764Declaration of Domicile and Citisenship 1831.~`~
TO THE STATE ANO COUNTY TAX ASSESSOR,
ST. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the Stete of Florida that 1 am filing this day in eooordarxe and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of C~int ~~v~ds Bet~n.,.
(City) (State)
and 1 resided at ~ ~2 I~en Are. ~ 3C However I have changed my domicile
(Street and Number)
ro and am and have been a bona fide resident of the State of Florida since 30th day of
lblaguat , i9._bB~, and I reside at 173 CaloOSO Street
(Street and Number)
FORT MERLE, SAINT LUCIE COUNTY, RORIOA
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, a relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
' ~ FILED AND RECORDED'
ST. LUCIE COUNTY, FLA.
~- RFCORO VERt~lEO
i8310~
'69 EP 16 PN ~ ;. 2 0
~~
ROGER ~ OITRAS
CLERK CIRCUIT COURT'
I FURTHER CERTIFY that I will comply with all other requirements of a IeRal 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.
:= ~ ' -
== `•i' . ~:1;.::sue. _ 7
r.. ,
"'~ _ '' ~to e++tl ~sL(Siaribed before me this
/ to 1
:!A~ .
,ROGER 'OITRAS
CIRCUR COURT
gy n'- D.C.
My Commission expires
(To be .xawted in duplicate and original filed wiMr Clerk Cirwit Court, and duplicate with Tax Asa.saor.)
auor< ~ (9 PAGE 2762
No. 13
AT CY H. HAIIYBS
(Name)
173 Calaoao Street
(Address)
16th
day of September t9 69
•
.Notary Public
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