HomeMy WebLinkAbout2796Declaration of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
ST. LUCIE COUNTY, FLORIDA:
Covington
(City)
:183135
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformiy with Chapter 222, Section 222.17, Florida Statutes.
I was formarly a legal resident of
and 1 resided at
1002 Amsterdam Road
However 1 have lunged my domidie
(Street and Number)
2nd
ro and am and have been a bona fide resident of the State of Florida sirxe
September , ~q 69 and i reside at
FORT pldtCE, SAINT LUCIE COUNTY, RORIDA
308 So 32nd street
day of
(Street and Number)
and this statement is to be taken as my declaraYwn of citizenship, actual legal residence and domicile in the State of Florida.
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.)
Bntering~ Tho>aasC. Roet)~Cer in the 2nd grade
~ Rhonda G. in the 1st grade
FILED AND RECORDED
ST. LUCIE COUR7YYFOLA.
:~F_~r±F:. c~K
183135
'S9 SEP 18 AM 9 ~ 38
~~
~OG~.-~ ~ OITRAS
CLERK CIRCUIT COURT
I FURTHER CERTIFY that i will comply with all other requirements of a legal resident of this State.
1 FURTHER CERTIFY that 1 have no intention ro return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT-LUCIE COUNTY, FLORIDA, permanently.
~y~~ and subsuibed before me this 18th
.: to
,,,:..
-~
ROGER rO1TRAS
uRCUIT couRT
gy o.c.
Lentuclty
(Stab)
~•
(Name)
Carl T. Roetker
(Address)
- day of September , ~q 69.
Notary Public
My Commiu'ron expires
(To Ire exewted in duplicate arrd original filed with Clerfc Circuit Court, and duPliu» with Tax Ateeseer.)
No. 13
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