HomeMy WebLinkAbout1417 Declaration ot Domicile and Citisenship 1858~~ '
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TO THE STATE AND COUNTY TAX ASSESSOR, i
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in actordance and
in conformity with Chapte~ 222, Section 222.17, Florida Statutes.
I was forme~ly a legal resident of ~Ordeo _ IndiiDi
(City) (StaM)
and 1 resided at __Rt ~~Z _ However 1 have changed my domiti~e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 29th day of
_N~.~~r_ , 19
69 , and 1 reside at ~ou 616~ 1v7pR ROlj?at St.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence a?~d domicile in the~State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment f
at former domicile, removal of family to new domicile, purchase. of home, etc.) ?
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s
Sstablish residence
FILED AND RECOR~EOi
ST. LUCIE COUNTY. FLA. ~ ~
_ ~?:.CO?~ VE~IFIED
188814 ~
'ZO JAN 26 A~I II: y3 ~
1
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i
t'~.~'.:{`~:i :-.O~ i PHS =
; CLERK C,RCUIT COURT~
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I FURTHER CERTiFY that 1 will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
P
(Name)
616 Rolyat St., Pt. Pierce
~ ' ~ (Address)
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= Sworn to and~subac'ribed before me this 26th day of Ja~Vaty , 19 70
• . .
. ~ . ' RQGER rOITRI~?`s ~
~ K Cl~CUI'T COURT Notary Public
r
By D.C. My Commission expires
(To be executed in dupliuf~ and orininal ~il~d with GKk Circuit Couif, and duplicst~ with Tax Assa~or.)
gooK 182 ~~E 1415
No. 13 _ _ . . . _ .
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