HomeMy WebLinkAbout0357 Decla~ation ot Domicile and Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
Si, IUCiE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in tha State of Florida that 1 am filing this day in accordance and
in conformity with Chapter 222, Section 2Z2.17, Florida Statutes.
Kankakee
I was formerly a legal resident of ~ ~
- ~ 11 i no t s
~ (Ciry) (State)
and I resided at _ 565 South Wal l Street
. However I have changed my domicjle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since _~____~20th _ _ _ day of
December 69 1641 Seaway Orive
- . 19----• a-_ ! reside at
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaratiar~ of citizenship, actual legal residence and domicile in ihe State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicite, purchase of home, etc.) .
Purchased home located at 1b41 Seaway Drive, Fort Pierce, St. Lucie
County, Ftorida, more particuiarly described as follo*?s:
Lot 6 of Block 13, of FORT PIERCE BEACH SU90IVISION,
according to a revised plat thereof recarded in P1at Book 8,
page 29 of the public ~ecords of St. Lucie County, Florida.
FILEO AND RECORDED~_
ST. LUCIE COUNtY, FI.A.
~n~.^ `d~Ri~i~O
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~ ~TQ ,~pta 7 PE~ 3} 36
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1 FURTHER CERTIFY that I 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 domic.ile, a~d ! intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
. . ~ , ~ ~ , ' )
~ (Name) C1 yde W. Gi bson
. ,
~ , ~ 1641 Seaway Orive
~ ' ~ -
~ . (Address)
~ 30th Oece~nber 69
~ Sworn to and subscribed before me this day o , -
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~ ROGER POITRAS `
~ CLERK CIRCUIT COURT Notary Pub
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~ By D.C. My Commission expires - -s a
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(To b~ sxecuted in duplicate snd ori~inal filed with Clerk Grcuit Cou~f, and dupliute with Tax As~essor.) -
F~ aoox 182 P~~E 355 ~
r:o. 13