HomeMy WebLinkAbout0615 Declaration ot Domiclle and Citizens~ip
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TO THE STATE AND COUNTY TAX ASSESSOR, •
5~. IUCIE COUNTY, FLORIDA:
This is my deciaration of Domicile and Citizenship in the State of Flo~ida that I am fili~g this day in aooordanos and
in oonformiiy with ~hapte~ 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of westchester Z11~
. Kiy) (Sta»)
and 1 resided at 2100 $uf f OlY Avt. , However I have charped my domivle
(Stroet and Number)
ro end sm and have been a bona fide resident of tJ~e Stsb of Floride sinoe Sth day ofi
September , 19 69, a~ i reside at 875 Aiross B ivd Post St. Lucie
(Street and Numl~)
FORT NHtCE, S/?INT LUCIE CAUNTY, R.ORIDA
and this statement is b be taken as my declaration of citizenship, actual legal resida~ and domicile in the Statei of Florida. '
(Insert here any pertinent fads, such• as sale of property or business, or relinquiahment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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Batablishing residence
FtLED AND RECOR~ED`
ST. LUCIE COUNTY. FLA. _
RE:CQRC V=RIFIED
- 1s3~3s
'69 OCT I AN 9: 37
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!~0 ~t~ ~ F~OITRAS
4 CL~RK CIRCUIT COVRT
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1 RJRTHER CHtTIFY that I wtll oompty with all otfier roquiremsnts of a lepal rosident of thts State.
~ -t~Fl~ICfHfR C~ttTiFY that I have no intention to retum to my former domi~ile, and 1 int remain in ~ORT
~ +,t..,.,•,~r:rj ~ .
PlHtCErSA?~l~ : ~ ~UNTY, fLORIDA, permanently.
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; ~ . ~`r`'' ~ • - (Name).
: ; ~ : . Syi~ester Yisciotts .
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~ ~ ~ ~ ~ ~ ~t3 (Add~ess)
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ls~ O~ctober 69
Sworn to and subsuibed before me this day of - , 19 .
rtoa~ rom~?s
CIRCUIT COURT Notary Public ~
By ~ D.C. My Commiasion expires
(Te b~ ~xseul~d in ~uplical~ and ori~inal fi{~d witb Clwlc Cirwit Cou~f, and duplicah wilb Tax A~~a
„ ~ . dooK 180 613
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