HomeMy WebLinkAbout2973 ~
Decla~ation ot Domlcile a~d Citisenship ~
TO THE STATE AND COUNTY TAX ASSESSOR, ~8`~.79~ t
Sl. IUCIE COUNTY, FLORIDA:
This is my detlaration of Domicile a~d Citizenship in the State of Ftorida that 1 am fili~g this day in atoordance and
in conformiry with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal ~esident of QY6t. and Par~__ ~+Aitg
' (City) (State)
and I resided at 88~S8rit8 F@ I,Bri@ _ However 1 have changed my domitile ~
(St~eet and Numbe~) ~ ~ ~
to and am and have bsen a bona fide resident of the State of Florida since 30th_ day of ~
1
jJanuar~ ,~934 , and 1 reside a~ 450 Prima Vista Blvd. ~
(Sireet and Number) ~
FORT PIERCE, SAINT IUCtE COUNTY, RORIDA !
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida. ;
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(Insert here any pertinent facts, such as sale of property or business, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
F?ZEO ,~N~ RECOROEO
~ IUCI~' C~~h~TY, F~~ :
Establishing residence ~r~-^~~' ~ ~
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~ '~0 FEB I1 E
P~f 2 ; 27 ~
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~`Efi~'~ C'RCU1T COURT
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~ I FURTHER ~ERTIFY that I will comply with all other requirements of a leyal resident of fhis State.
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~ 1_ FURTHER CERTIFY that I have no intention to return to my former domicule, and I intend to remain in FORT
PIERC~ ~ ~E COUNTY, FLORIDA, permanently_
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os. : (Name)
~'s Q = Vera Alene 8emington ( ~rs ~6ark )
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Sworn to'and subscribed before me this 17th d'ay of February ~~q ~j0 _
_ - ROGER POITRAS
LERK CIRC COURT Notary Public
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~ B ~'L D.C. My Commission expires
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(To b~ ~xecuted ie duplicat~ and original filed with Cl~rk Circuh Cou~, and duplicah with Tax Ass~ssot.) :
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