HomeMy WebLinkAbout1062 Deciaration of Domicile and Citizenship _
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIORIDA: , ~
This is my declaration of Uomicile and Citize~ship in the State of Florida that 1 am filing this day in actordance and ~
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in confo~mity with Chapter 222, Section 222.17, Florida Statutes. ~
I was formerly a legal resident of Forest Tllinoi~ _
~C~ty~ (State)
and I resided at S88_Timber Lane However I have changed my domicjle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida sinte 28 _ day of
January , ~9?~ , and I reside at 3042 S~ia~.Yallo-~ -
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FIOBIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or businessr or relinqu+shment of employment
at former domicile, removat of family to new domicile, Rurchase of home, etc.) ,
Establishing residence
FiLEO ~yD RECORDEO
LUC1~. ~OUNTY. FLA.
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r~`r.`y~ :~'T COUR7
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legai resident of this State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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: (Name) grancia x. 0'Beirne
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(Address)
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Sworn to and subu~ibed before me this 5th day of l(arch , 193~._.
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`^l; r~~_~EI~,~~O~TRAS
~ :~tC CIRG~11` COU Notary Public
,Y ~•.~z' . .~E:r. ~
s By t, D.C. My Commission expires ~
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4` . . ~f~~C• ~ 41'~y ~R~ ~ . ~
~,~q:~iiacvfsd in duplicate and oriQinsl filed with UKk G~cuit CouK, snd dupliut~ with Tax Assessor.) ~
` . ~ r . . . • O K y
~83 P~soss
No. 13
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