HomeMy WebLinkAbout0118 Oeclaratlon ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Si _ LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and
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in confo~mity with Chapter 222, Section 222.17, Florida Statutes. '
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Huntington Station L. I. New York
I was formerly a legal resident of -
~C~ty) (State) ~
42b Walt Whiteman
and 1 resided at However 1 have changed my domitile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since __1Si day of -
Y ~1ve- ;
, 19__-, and 1 reside at _ i
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA
,
and this statement is to be taken as my declaration of citizenship, actual legal residence a~d domicile in the State of Horida.
(Insert here any pertinent fads, such as sale of property or business, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) .
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Es~ablishing residence
FlLED tiND RECORDED
S LUCIE COUNTY, FLA.
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18;828
'70 J~'~ 5~t~ 10 : 5 2
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.c?~:._ :~o~ ~ a~~
CL.~~RK ~if~CUfT COURT
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I FURTHER CERTIFY that 1 will comply with al) other requirements of a lega) resident of this State. ~
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1 FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remain in FORT
PIERCE, SAIfyZ,~,UCIE COUNTY, FLORtDA, permanently.
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_ . . ~y~~,t~s~
_ . ' . (Name)
~ - ~ Fred W. Kern
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- (Address)
Sworn~to and subscribed before me this Sth day of January ~q
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ROCER POITRAS
~ LERK CIRCUIT COURT Notary Public
~Ot .-lcC~
gy D.C. My Commission expires
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~ (To bs sxecuted in duplicate and originsl filed with Clevk Grcuit Court, snd dupliats with Tax Assessor.)
~ a00K ~O~ FACE ~~8
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