HomeMy WebLinkAbout0186 -Decla~ation ot Domicile and Citize~ship ~
TO THE STATE AND COUNTY TAX ASSESSOR, ' _
i
Sl. IUCIE COUNTY, FLORIDA:
'n rdsn e and ~
This is my declaration of Domicile and Citizenship in the State of Flonda that 1 am filing this day ~ acco t ~
in conformity with Chapter 222, Section 222.17, Florida Statutes. -
I was formerly a legal resident of _H~gh~siovvn New Jersey .
(City) (State)
and 1 resided at __-~.__g~gpj~gg__$p.g~ However I have changed my domiti~e
(Street and Number)
to a~d am and have been a bona fide ~esident of tHe State of Flo~ida since __~~~ZL- day of
_----~n~g~ . 19~~, and I reside at R~~~t~ 2 Rpz 2'j69E
(Street and Number)
FORT PIERCE, SAIN? LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida.
(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.)
Tax Purposes ~d Homestead .
' ~'~LEO ~r~p R~CORDEO~
i ~T• LUCIE COUNTY, F(.q, it
~
t ~~~~Qr~^ y=',;1F' €
l90 F ~
~ 152 ~
l - '70 FEB 2 0- P~ I: 5
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
~
I FURTHER CERTIFY that I have no intention to ret~rn to my former domiG~e, and I inte~d to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ Charles F. gendall ,
~
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~ i ~3 o-~C ] 6 y ~ ~
(Address)
Sworn to and subscribed before me this D~ day of "t-~ , 19.,z~..
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- RO(iiER.'POli~tllS ~
.CLERK .CfR~'ili1T ;zQURT Notary Public i
_ 6y ~ ;~Ll_' ~:5~:. -`~~~Xlrl ' D.C. My Commission expires i
• ~ ~ ~ c~ - t . ~
.rt~-'* •C.'1
~ (To bs ~~xecNted ~in duplicsts and originsl filed wHh Clerk Circuit Court, and dupliute with Tax Assest~or.) `
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.1 . ~ R 183 1 6 `
:-3
600K PA6E S
No. ? 3
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