HomeMy WebLinkAbout0338 ~eclaration ot Domicil• and Citizenship •
TO THE STATE AND COUNTY TAX ASSES50R, •
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ST. WCIE COUNTY. FIORIDA: ~
This is my declaration of Domicita and Citizenthip in fhs Ststs of Florida Mat 1 am filinQ this day in aooord~not end ~
i~ oot?formiy with Ctiapter 2Z2. Section 222.17, Norida Statutes.
1 wes formarly s leqal resident of ~~ta ~O1uRbit .~$•A•
(City) (Stat~)
and 1 rosided at . Howevef 1 hava tharqed my domWk
(SNcet and Nurnber)
ro and am and have ~esn a bona fide ~eiident of the Staro of Flor'ida sinoe ~Ct~bet
, 19~.~, snd 1 mside at 107 No• 17tb Stseet
_ (Street s~d Numbeo)
ro~ Neec~, s~u~ <<uc~ counnr, aoRmw ~
and this statement is to be taken aa my dedaratio~ of citizenship, actual legal residenoe and domicile in ths Stats of Florida.
(Insert here any pertinent facts, such as sale of property or business, or ~elinqul~ment of employment
at fornser domicjle, removal of family to new domiale, purchase of fame, etc.)
Placing children in pub2ic school -
Biiaabeth. Manricio and Bdgsr ibdq~t~t Bahaaoa
FILED AND RECORQED
ST., ~~~~E COUNTY, F~,~,
_..O~n ,~ERt~'!Ep
, 1s~;;562
69 c~~ 5 PM !2:
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, ~n
F41TR
' . ~~F~K CIRCUIT CQURT
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1 FURTHER GERTIFY that 1 will oomply with sll other requirerr~ri of a le~al rosidsnt of this State. -
1 FURTHER CERTIFY that 1 have no intention to retum to my formef domicjie„and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ ~
tName) HptsCio Bshsmo=t
(Addross)
Sworn to and subscribed•,,b~qfote me this 2Sth day of Sevtember ,~q 69 ,
f,,, _ .
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ROG[at rO1TRi!?~•. - °,F ~ -
U,ERK CIRCUI~ CQUR1' Notary Publk
•1- c.~ -
5 .
gy _ D.C. My Cornmission expires
_ - 4 ~i:
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tte b. .x.~,~hd iin~ d~pWu~: .nd o.i~in~i Rl~d wilb aKk cka~it cowf, ae~d dupuw+. wilh Tax A..a~o.a
aooK 180 338
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