HomeMy WebLinkAbout0622 ~eclar~tion ot Domicile and Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR, 18604~ ~
Sl. IUCIE COUNTY, FIORIOA:
This is my declaration of Uomicile a~d Citizenship in the State of Florida that 1 am filing this day in attordance and
~n conformity with Chapter 222, Section 222.i7, Flo~ida Statutes.
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I was formerly a legal resident of ___~Q~A~~ ~~IC'~ ~
~C;ty~ ' (State)
and 1 resided at ?~23__B~Zi?b~th St. However 1 have changed my domi6ile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 9th day of
_ ~uoe______ ,~9_64 , and 1 reside at Rt. 2~ Box 5381 ~ Pt. Pierce ~ Fla~
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Ho~ida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishmen~ of employment ~
at former domicile, removal of family to new domicile, purchase of home, etc.)
FILED ANO RECOROED'
Honestead ST. LUCIE COUNTY, FLA.
`~r C~PD ` FRIFIEO
-~86~34~
'69 NOV 2! AN I I: I 3 ~
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?i~C~+t r'OITR:;S
CLERK CIRCUIT COURT:
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~ I FURTHER CERTIFY that I will comply with all other requirements of a(egal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domicjle, a~d I intend to remain in FORT
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~ PIERCE, SAINT IUCIE COUNTY; ~LORIDA, permanently. •
~ r ~.~...~L~l. ~-~~a..-,
~ BBRNHARD UBBBNJANS ~
~ (Name) •
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Rt. 2, Box 5381, Pt. Pierce, Pla.
(Address)
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- Swom tq,~nd. subscribed before me this 213t day of No~ember , 19~9. ;
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,~1: CIRCUIT CQP/~tt Notary Public
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~y< g ~ D.C. My Commission expires
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~ (To be'~xicut~d~'in duplicate and originsl ~ilsd with Ci~rk Grcuit Court, and dupliuts with Tax Ass~stor.)
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