HomeMy WebLinkAbout0244 Oeclaration ot Domicile and Citizenship
TQ THE STATE AN~ COUNTY TAX ASSESSOR, 3
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citize~ship in the State of Florida that 1 am filing this day in accordance and
im m~formity with Chapter 222, Sectio~ 222.17, Ftorida Statutes.
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1 was formerly a legal resident of __~.4yL._~4.5~_~-X--- NCW YorY _
(City) (State)
and I resided at __?15 Adam3 Street . Brooklqn N.Y!_ However I have changed my domitile
(Street and Number) ~
to and am and have been a bona fide resident of the State of Florida since 2Sth day of
A»gust , i9~~, and I reside at Rt. 2, Box 2585Port Pierce, Florida
fORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and dcmicile in the State of Horida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of emptoyment
at former domicile, removal of family to new domicile, purchase of home, etc.) i
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F~LEO qN
ST. LUC?E Cp ECORDED' ?
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G CLERK '"Ot7F.4S~
CiRCU1T COURT:
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I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
1 FURTHER CERTIFY that I have no intention to return to my former domiCile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently. ~
(Name)
Pred ieber
RT 2, Box 2585*_.. Fort Pierce ~ Fla.
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~ Swom to and subsuibed before me this 6tb , day of Tanuary m ,~q 70 ,
~ R Ht POITRAS
OG
~ CIERK CIRCUIT COURT Notary Public
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~ gy ~ G- D.C. My Commission axpires
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~ Ro b~ ~xeait~d in dupliute and original fiied with Clark CircuN Court, and duplicat~ with Tax /lss~ssor.)
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