HomeMy WebLinkAbout2261 Declaratlo~ ot Don~icil• and Citize~shtp
' TO THE STATE AND COUNTY TAX /lSSESSOR,
51. IUCIE COUNTY, FLORIDA:
This is my declaration of Oomicile and CitizensF~ip in the State of Florida that 1 am filin~ this day in saordence and
in oonformity with Chapter 222, Settion 222.1 Florids Statutes.
1 was forme~ly a legal resident of Cletreland .Oh~ n
(City) (Sta»)
and I resided at 1913 11es?vier Avenue . Howevef 1 have chanysd my domic3le
(Street and Number)
to and am and have baen a bona fide resident of the State of Florida since 3128f7~ day of
- , 19 , and I reside at 1222 O~sond Ave _
(Strset and Number)
FORT r1~CE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my decla~ation of citizenship, actua) IRgal residenos and domicile ~n ths State of Horida.
(Insert here any pertinent facts, such as sale of property or busineu, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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3andra Anderson;Richard Andereon
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st.~~~~~o+~~
REC~~D ~8.1?IFtEI~ .
. : ..191599
'i0 MAR 30 PN t2• q~
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ROGERc 01T~(AS.
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I FURTHER CERTIFY~that I will oomply wifh all other requirements of a le~al resident of fhis State.
I FURTHER CERTIFY that 1 have no intention to retum to my former domiCile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
(Name)
(Address)
'~.~~,T~'ii:,;y~~~ . .
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~ 30th
5~oo~A;~~i'~'~,Gi~s4ribed before me this day of ~r~ , 19_IQ.
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• ` ` . _ ~ iW~' Notary Public
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BY r~ D.C. My Commission expires
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(To~b~.!o~!i~d iu d~plicats and o.i~in~ fif~d with Cl~ic G~ Couirl, and ~plkab wiN~ Tac A~Mao~.)
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