HomeMy WebLinkAbout0225 Declaration ot Domicile a~d Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
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Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal ~es~de~r of p~tomac Marylend
(Ciy) (State)
10910 Chandler Road
and 1 resided at However I have changed my domiGle
(Sireet and Number)
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to and am and have been a bo~a fide resident of the State of Florida since January 28 day of
_ _ , 19~_, and I reside at Route 2~ Boa 3264-A
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my decla~ation of citizenship, actual legal residence and domicile in ihe State of Norida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establishing residency
FILED AND RECORDEO
s7. ~UCtE COUN7Y. FLa. ;
R~ Ct?R~ :'~~aIFtED
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'69 NOV 17 1lMM 11:21 ~
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~ec=~ K ~-q~~.s
CLERK CIRCWIT COURT
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1 FURTHER CERTIFY fhat I will comply with all other requirements of a(egal resident of this State.
1 FURTHER CERTIFY that I have no intention to return to my former domi4le, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_
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(Name) David V. Rlckett8 ;
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~ 17 November
~ Swom to and.wbscribed before me this day of , 19 .
ca
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~ ROGER PORRAS ~
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~ CLERK C~RCUR COURT Notary Public `
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~ 8y ~ D.C. My Commission expires
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~ (To b~ ~xecuted~in dupliwte and o?iginal fil~d with CIKk Grcuit Cou~t, and duplieat~ witb Tax Ass~or.)
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800K
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