HomeMy WebLinkAbout2807 Decla~ation ot Don~icile and Citize~ship
TO THE STATE AND COUNTY TAX ASSESSOR, i
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51. lUC1E COUNTY, fLORiDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that 1 am filing this day in acaordance and
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in confo~mity with Chaptet 222, Section 222.17, Florida Statutes.
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I was formerly a legal ~es~denr of _ New York New York
(City) (Stab)
2750 Cz'estoll Avenue However I have chan ed m domir,ile
and 1 resided at 9 Y
(Street and Number~___,
to and am and have been a bona fide resident of the State of Florida since MBTCh ~ ~ 967 day of
_ , 19 and I reside at 106 ROSAlYYI Avenue
(Sireet and Number)
FORT PIERCE, SAIN? LUCIE COUNTY, FLORIDA
ar~d this statement is to be taken as my declaration of citizenship, attua) legal residence and domicile in the State of Ho~ida.
(Inse~t here any pehinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
ldember of Armed Forces; intenda to live permanently in Ft. Pierce
upon release.
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FI~ED AND RECORDED°
ST. LUCIE COUNTY. FLA. ;
COR^ V=?f~4~p `
18`7662
~ss o~c 3o PM i: s
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;:OG_ ? 17R~S
CL~RK CIRCUIT COURT~
1 FURTHER CERTIFY that I will comply with al) other reqvirements of a legal resident of this State.
1 FURTHER CERTIFY that ! have no intention to return to my former domiti~e, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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(Nam Henry A Daniels
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..ry.-
~ (Address)
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~ , - Swotri;to and subscribed before me this 30th day of December ~q 69
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~ ROGER' i~DtTRAS - ; ' J
~ CLERI~ C~~CUIT COURT Notary Public
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gX • ' ~ D.C. My Commission expires
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~ Ro bs ~xecu»d io duplicat~ and ori~inal ~il~d with CIKk Grcvit Court, and duplicat~ with Tax Ass~ssor.) ~
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~ go~ ~81 P~E2807 i
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