HomeMy WebLinkAbout1234 ~
~
~
~
Declar~tion ot Domtcile and Citizenship
184231
TO THE STATE AND COUNTY TAX ASSESSOR,
51. lUCIE COUNTY, FIORIDA: ~
This is my declaration of Oomicile and Citizenship i~ the State of Florida ihat 1 am fili~g this day in aooordanoe and
in conformiy with Chapte~ 222, Section 222.17, Flo~ida Statutea.
I was forme~ly a legal resident of Che~y Chase
(City) • (Stats)
and 1 resided at Howevef i have changed my domic3le
(Street and Number)
ro and am and have been a bona fide resident of the State of Florida since Septe~ber 12 _ day of
_ , 19~4, and ! reside at 2901 ~rningeidc Blfd,_~prt St LuC~!
(Streat and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA ~
i
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. y
!
(Insert here any peninent facts, such as sale of property or business, or relinquishme~t of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
8stablishiag reaidenc~ j
FILEO AND RECORBED'' ~
~ ST. LUCIE COUNTY.. Fi.p.
RECOR~ V~R}~tED
-t84~31
'69 OCT 13 PM !2: 00
~ f; 7 G~ R~
p~nn~~t Qw
CIERK CIRCUIT CO RT;
~
~
t
k
t
!
1 RJRTHER C'ERTIFY that I will comply with all other requiremsntt of a leqsl resident of thk State.
t FURTHER CERTIFY thet I have no intention to retum to my former domidle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTI(, FLORIDA, permanently.
,
? "
= (Name) .~~es BIOMO
? .!~-,C~.y~.~i~ ~ ~
~ (Auar~ Jesnie S Brorn
; - .
. . •
Swp~i to•end wbscribed before me this 13 day of ~t0~t ~ , 19~_.
_
~ : _
_
~
~ ;,~.t~K~
~.~~1T
URT Notary Public
~ ' ~ '
" ~
_ ~ : k,,,r
By D.C. My Commiuion expires
(To b~ uucurad ie duplleab and wipinal fil~d with CIKIc Cira~it Cour~, aed duplicah will~ Tax A~sora
, 3 , so~ s~l ~1~~'1
. . , : - _ . 'r.s~~ - _
~'o-~ ~
~
_ ny~c"~:w ~:C.'"`s..+~" . . ~ . ~F'w+i~~~~