HomeMy WebLinkAbout0178 ~eClaratio~ ot DomlCile and Citisenship
TO THE STATE AND COUNTY ~AX ASSESSOR,
Sl. LUCIE COUNTY, FlOR10A:
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This is my declaration of Domicile and Citizenship i~ the State of Florida that 1 am tiling this day i~ accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of - ~1
}i.}.- _ Nest Va. _
(City) (State)
and 1 resided at 10T~l2 West 4th St However I have changed my domiti~e
(Street and Number) ~
to and am and have been a bo~a fide resident of the State of Florida since Fe_bi'uar~ 1R day of
, 19?~ , and 1 reside at Route 4 Boz 632
(Street and Number)
3eminole Pazk
fORT PIERCE, SAINT LUCIE COUNTY, FL~DRIDA
and this statement is to be taken as my declaration of citizenship, actual leqal residence and domfcile in the State of Horida.
(Insert he~e any pertinent facts, such as sale of p~operty or business, or relinquishment of employme~t ~
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at former domic;le, removal of family to new domicile, purchase of home, etc.) ;
;
Rant~y Dean Cnr ry
F~LED AND R~COROED
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~ I FURTHER CERTIfY that I wil) com 1 with all other ~ uirements af a( al resident of this State.
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I FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. t
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(Name) gred Curre -
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~ Swq~n`~~~Nb~r+"6~d before me this -~0 day of Feb~a~' 19~ll_. ~
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3 ~IR~F~~¢.tl~ / Notary Public
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By D.C. My Commission expires
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(To bs ~xsi~itiib'Iri,e~up~e~ti ~and oripinal filed with Cl~rk Grcuit Gourt, snd dupliut~ with Tsx Atsessor.)
~ 60~1Qt~ PACE
o No. 13
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