HomeMy WebLinkAbout1572 18892~
Deciaration ot Domicile and Citlzenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my decla~ation of Oomicile and Citizenship in the State of Flo~ida that 1 am filing this day in acmrdance and t
in conformity with Chapter 224, Section 222.17, Florida Statutes. .
I was formerly a legal res~denr of - Babylon N~~1 York _
(Ciry) (State)
and I ~esided at __~~~nuekeIDUIIIIiCe~ R08d However I have changed my domicrile "
(Street and Number)
to and am and have been a bona fitle resident of the State of Florida since - 15th ~~y o#
_ ~uly_ , 19
69, and 1 reside at 1~.08 Yosemite Ct.
(Street and Number)
fORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legat residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as saie of property or business, or relinquishment of employment ~
at former domicile, removal of family to new domicile, purchase of home, etc.)
R
establish reaidence •
FI~ED qNp
ST. ~~C~E ~o~NCORp~Ep~
~`~~R~`~9 ER?FIEp~A.
a ~
'l~ JAN 28 PM 1 :
, I1
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i C f~~"~? r'Ofr +
E R R.,
; k CIRCV~ S
4
`f T COURT;
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~ 1 RIRTHER CERTIFY that I will oomply with al) other requirements of a leyal 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, FLORIDA, permanently. ?~GG~,P~1.L J~ C~%~ ~
~ '
~ l/ ~
~ DERICB 0. DARE -
~ (Name)
~ .
~ . . .
: '
- ~ 1508 Yoeemite Ct.
.'....-•or.
- .
• 'r~ , (Address)
- • . ~ ~ -
~ . ' ' y.I ~ ~ ' ~8 th January 70
::;Sr~rprn to and suttsv~~jJtc! before me this day of , 19 .
'g" ~j7 ~t~ • - ~ ' 4 ~ ~ I
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•
K Notary Public ;
~ ~~Gl~T~ COURT
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~ By D.C. My Commission expires ;
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;
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~ Ro b~ sxscut~d in dupliat~ snd ori insl fil~d GrcuR Court, and dupllut~ with Tax Ass~sw~.)
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~ ~ ~ PALE
BOOK -
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r~v. 13
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