HomeMy WebLinkAbout2345 i91653
Declaration ot DtamiCil• and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my declaratio~ of Domicile and Gitizenship in the State of Florida tfiat I am filing this day in aooo~dsnce a~d
i~ co~formity with Chapter 222, Section 222.17, Florida Statutes.
I was fo~merly a legal resident of ~unt8oi~-le Ala. _
t (City) (State)
and i res~ded ar 05_ Aarrison Ave However 1 have changed my domiG~e
(Streei and Number)
to and am mnd have been a bona fide resident of the State of Florids since -~t~ day of
October , ~q 68 , and ~ ~es;de af 1714 Lin~ood Ave.
(5treet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citi=enship, actual legal residence anti domicile in the State of Horida.
(Insert here any peNi~ent fads, such as sale of p~operty or busineu, or relinquishment of employment
at fo~mer domicile. removal o# family t~ r.ew domicile, purchase of home, etc.)
residence
Fi~p AaD RECOiZOEI~
ST. ~uCtE COUNTY, FLA.
RECORO V~RIFIED
191653
'TO I~IR 31 A~1 11:36
HOGER POIT l/' ~
CLERK C?RCUtT COURT~
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~ 1 RIRTHER CERTIFY that 1 will oomply with all other rsqui~srt~ts of s lesal resident of this State.
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I FURTHER CERTIFY that I have no intention to retum to my former domi4le, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIOA, permanently.
~~~^'~"L`~''~ ~iv- ~.;~z'~' l
ELWOOD W. KRBSAZ
(Name)
~•:•~;L:{~;:~:~::,;;~ 17~4 Lindwood Ave.
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" -=~~to ~ before me this 31$t day of ~arch , 19 7 .
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~ By ~ D.C. My ~ommission expires
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(To b~ ~x~cuf~d in duplicat~ and orisinal fil~d whb Cl~rlc Cirovit Court, and dvplits» wish Tax A~r.)
~ goaK1~3 P~~E2343 ~
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