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HomeMy WebLinkAbout2841 ~ _ ~ t Declaration ot Domicile and Citizenship ; TO THE STATE AND COUNTY TAX ASSESSOR, Sl. lUC1E COUNTY, FLORIDA: ' ; This is my decla~ation of Domicife and Citizenship in the State of Florida that I am filing this day in acoordance and ~ in conformity with Chapte~ 222, Section 222.17, Flo~ida Statutes. Tenn t I was formerly a legal ~esident of ____.~~1"~~~~_-------- - ; (City) (Stab) Route 3 - and 1 resided at - Howeve~ 1 have changed my domiCilc ~ ' (Street and Number) . 1 ! to and am and have been a bona fide resident of the State of Ftorida since A~~' 2g day of , 19 69 , and I reside at 4941 Ol@eride2' Ave21u@ ~ (Street and Number) i fORT PIERCE, SAINT lUC1E COUNTY, FLORIDA and this statement is to be take~ as my declarotion of citizenship, actual legal residence and domicile in the State of Horida. (Inseri here any pertinent fads, such as sale of property or business, or relinquishment of employment i at former domicile, removal of famiiy to new domicile, purchase of home, etc.) Establiahing residency and placing child in echool... Daniel Foa FILED ANQ RECORDEO ST. ~UC'.E COU"3TY. F~Q. f`~~ZC~ V~R~-'cD , 1gl~]g~ ' ; '69 DEC 30 PM 3: 21 ` , . I :.~,1;.;~;= ~~Qt'tZ~s ~ ~ ~LERK CSf2CUtT COURT : ~ ~ ~ ! t G cg i ~ ~ I FURTHER CERTIFlf that 1 will comply with al) other requiremenss of a legal resident of this State. ~ ~ 1 FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and I intend to remain in FORT ! ~ ~ ~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~ ~ ~ ~ ~ ~ , ~ (Name) 6@ O]C ~ ~ ~ _ , h (Address) s . : _ ~ ~ . . ~ " 30 December ~ 69 ~y ,~SWOrn.to end subscribed before me this day of , 19 . ~ ' f - . , . = : ROOER POITRAS ~ ~ ~ - ~I~Rf( ~IRCUIT COURT Notary Public ! ' ~ ~ ~ ~ gy D.C. My Commission expires _ ~ , ~ ~ ; ~ , . Ro b~ ~xecvted in dupliuro snd oriainal filsd with Cl~rlc Circuit Court, and dupliuN with Tax Ass~swr.) ~ OR ~ ~ ~ aoo~~8~ ~284~. - ~ ~ ~ _ ~ ` ; , , ~ ~ ~ _ ~ _z._~~_.