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HomeMy WebLinkAbout2526 ~ Decla~ation ot Domlcile and Citisenship ; TO THE STATE ANO COUNTY TAX ASSESSOR, ~ 51. LUCIE COUNTY, FLORIDA: ; , , ~ This is my declaration of Domicile and Citizenship in the State of Fla~ida that 1 am filing this day in accordance and ~ in conformity with Chapter 222, Section 222.17, Florida Statutes. ~ ~ R 1 was formerly a lega) resident of Ston~ Brook L. I. Nex York _ € (Ciy) (State) ~ ; e 1 and 1 ~esided at 1~_M~: _f~Ley Rd•_ However I havechanged mydomi~ile 1 (Street and Number) ~ Dec. 1 ~ to and am a~d have been a bona fide resident of the State of Florida since day of ~ _ 19~4__, and I reside at 601 Seaxav Drive - E 26 ~ (Street and Number) FORT PIERCE, SAINT LUCIE COUNTY, RORIDA • and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. (Insert here a~y pertinent fads, such as sale of property or business, or relinquishment of employment ~ _ at former domicile, removal of family to new domicile, purchase of home, etc.) ' Purchused home at 1614 Binney Drive, Ft. Pierce, Fla., for a permanent residence ~~~lfiO:AND =RE~tDRQfO' S LUCtE COU~!'1~Y.~FL'A. `1~ f.t~Pt? ~ERi~'tED l9l`~'6~7 '7Q APR 3 AM II: II cr~.c.J :•:±:l.r~ t•OtTRk~ ~~~~K ~~~CUlT COURT i - - ~ ~ ; I ? E ~ ~ ~ ~ ~ : I FURTHER CERTIFY that I will comply with al) other requirements of a legal resident of this State. ~ ~ 1 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. ~ ~ ` ~ ~ uC ~1 ~ ~ " ~ ~ ; g (Name) glmer A Mapp ' ~ ~ ~ ~ - I ` (Address) ' _ . I ~ _<,?,~t.~;`:;;,'~ ~ '`+'°''SyYotn: o~a~d subscribed before me this 3 day of ~ April ~ ~q 70 , ~ ~ : .~.:,='L.: l•-:, ~ : f: ~~,,s~~:~~;}: ~ u . . • ' Rf~61~=_ POITRAS ~ ~ _ i ;CIRCUIT COURT Notary Public ~ = _ ~ ti ' t y= ' r i~~~~ D.C. My Commission expires ; ~ r ~S;,eQ ~ ~ ~ ` ~ ~ ~ ~ (To bs executed in duplicate and original filsd with Clerk Grcuit Gourt, and dupliute with Tax Asssssor.) ~ ~~K183 ~F2523 = f Fao. 1 ] _ . ' . ~ ~ ~ - - _ ~ .x - . w'~"%.~a _.z~:~ . . . _ . - _ ~ . - _ ~z t.