HomeMy WebLinkAbout2770 Declaratio~ ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Si. IUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Flo~ida that 1 am filing this day in actordance and
im m~formity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of -._](,praLiiel.d_ v~.. -
(Ciiy) (State)
and I resided at ___106~ 3o._Aiver Street However 1 have changed my domiG~e
(Street and Number)
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to and am and have been a bona fide resident of the State of Florida since _~g~~
~2 day of
_ , 19
~2, and I reside at 3119 Overbrook Drive ~
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
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(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) j
Eetabliahing resideney
FILED AP~D RECORDED~
ST, LUCIE COUtiTY, FLA.
r::^^'~~ VE~l~'FO
18:~b2~
'ZO FEB I 3 PM : Oq
i t'.~ti~~L' . t~t..S
~ CLEi~K CIRCUIT COUR
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~ 1 FURTHER CERTIFY that I will comply with al) other requirementa of a lega) resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and 1 intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ Q-C,c.~ . _
~ (Name) ~nde E. Adams
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, (Address)
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Y s:;,j:: :
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~ ~a 'q ~~~ia~rXi!#(~~a~lubacribed before me this 13 day of Februarv ,~q3Q_.
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K 'f~~`p~~~A~~
OURT Nota Public
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~ By + D.C. My ~ommission expires
~ ~ . .
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~ (To b~ ~xecut~d in duplicate and original filed wjth CI*rk Grcuk Court, and dupliut~ w~th Tax As~stor.)
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~ ° R 182 ~?~27~5
No. ~3 ~OOK
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