HomeMy WebLinkAbout2159 Decla~ation at Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR. ~84926
Sl. tUCIE COUNTY, FIORIDA:
Tfiis is my declarotion of ~omicile a~d Citizenship in the State of Florida that 1 am filing this day in aooordanos and
in confo~mity with Chapter 222, Section 222.17, Florida Statutes. -
I was formerly a legaf resident of Qu~nT I~ssaachusetts
(City) ~a»)
and I resided at --~.42~i Stree! . Howevar 1 have changad my domWie
(Street and Number)
to and am and have been a bona fide ~esident of the Stata of Florida since Tth dsy of
_ ~ Oc#ober ,)9 69 aRd I reside at 1919 llllyoffi na A~enue
(Street snd Number)
FORT PIHtCE, SIUNT Lt~C1E COUNTY, FLORIDA
and this statement is to be taken as my declarotion of citi=enship, actual legal residence and domicile in the State of fiorida.
(Inse~t here any pe~tinent facts, such as sale of property or busineu, or relinquishment of ernploymen!
at former dom~cile, removal of family to new domicile, purchase of hane, etc.)
Bstablish Residency
FIt;E.p ,c.typ RECORDED
Purchased home ~T• COtiNtY, :f~A.
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CLERK ClRC~It~ CO~RT
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I FURTHER GERTIFY the~t I wil) oomply with all other requiremsnts of a Is~al ~eside~t of this State. -
1 FURTHER CERTIFY that I have no intention to retum to my former domi~ile, and I intend to remain in FORT
QIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~a~) George . ry
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s~itisuibed before me this 28t~! d~y ~CtObe! 19~.4
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'~:.~~~~~~~COURT Notary Publk
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By D.C. ~ My Gommiss'ron expires
(To b~ uacuhd in duplicah and ori~inal fil~d witb Cle~lc Ciraiit Courf, and d~licaf~ wirh Tax AsMper.)
BOOK~SO PACf~~il1
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