HomeMy WebLinkAbout2240 ,iv ~a.v w a
Decla~ation ot Damicll• and Citize~ship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FlOR10A:
This is my declaration of Domicile and Citizenship in the State of Florida that I sm filinq this day in sco~rdenoe and
in co~formity with Chapte~ 222, Section 222,17, Florida Statutes.
I was formerly a legal resident of ?,OAG TST.AND ~_YDt~~t
(City) (Ststs)
and 1~es~ded at Ferris Rd . S@Hf 02'a , However I have char~ged my domicjle
(Street and Number)
to and am and heve been a bona fide resident of the State of Florida sinoe ~ st - day of
ne _ember _ , 19~9 , and 1 ~esida at 27fl1 Cortez Blvd.
(Street and Num~ber)
FORT PIERCE, SAlNY LUCIE COUNTY, RORIDA
and this statement is to be teken as my declaration of citizenship, ectual leyal residence and domicile in the State of Horids.
~(Insert here any perti~ent fads, such as sale of property or busineu, or relinqvishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) ~
~
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F~~p pNp RECORDED' ~
H4me8teed S7.~tEC
RD ~ERIf EDLA.
1915a~
'TO t~R 30 l~l 10 : 33
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~Q~~~ ~o~TaAs
CIERK CIRCUI? COURT=
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~ I FURTHER CERTIFY that 1 will aomply with all other r uirements of a 1 I resident of this State
~i ~ .
1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and I_ intend to remain in FORT
PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently.
Ei~:-s-~w ~~~~t~,~
Ci~/
~TS "_~II,(~RRT
(Name)
2701 Corte~ Blvd.
(Address)
° Si~;'¢iv~i'N'W: ` ribed before me this 30th day of ~erch 19 70 ~
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