HomeMy WebLinkAbout1217 Declaration ot Domicile and Cthienship
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TO THE STATE AND COUNTY TAX ASSESSOR, #
Si. IUCIE COUNTY, FIORIDA;
This is my declaration of Domicile and ~itizenship in the State of Florida that 1 am filing this day in atoordante a~d
in conformity with Chapter 222, Settion 222.17, Florida Statutes.
I was forme~ly a legal resi~ant of AlBZ811dr18 Virginia
(Ciy) (Stab)
and 1 resided at 5~50 O~ley FoY'ge Dr1ve ,~Wever 1 have changed my domicile
(Sireet and Number)
to and am and have been a bona fide resident of the State of Flwida sinoe ~ 24th day of
n~n _mh_gr , 19
6~, and 1 reside at 4000 Greenwood Drive
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of propery or business, or relinquishme~t of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) ;
Establiahing residence and applying for homestead
~88`7U4
. ~ RI~ED ANO RECORD~D'
ST. LUCIE COUNTY. FLA.
RECOR~ VERlFlED
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't0 JAt~ 22 P~t I :29 ~
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~<e~~P. FOfTR~S
CL~RK ClRCUIT COURT~
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1 Ft1RTHER ~ERTIFY that 1 will oomply with all other requirementa of a layal resident of thts State.
I FURTHER CERTIFY ihat I have no intention to return to my former domicjle, and I intend to remain in FORT -
PIERCE, SAINT LUCIE COUNTY, FI.ORIDA, permanently.
``~..,t,nri:ri,~,~r, ' ,
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i- Mame)
_ . • 8aymond E. Stanley
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~ (Address)
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• ' ' . 22nd January 70
'~.Sworn to and subxribed before me this day of , 19 .
RO~'3ER POITRAS
K CIRCUIT COURT Notary Public
D.C. My Commission expires
(To b~ ~x~cvMd in duplicat~ and oripi~al filed wi11~ qNk GrcuM Courf, snd dupliuh with Tax Ast~s~or.~
~ , 3 so~K 1~~ ~A~~ 12~.5
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