HomeMy WebLinkAbout0628 Declaration ot Domlcile a~d Citixe~shiN
TO THE STATE AND COUNTY TAX ASSESSOR. 1`~8 ~~i
Sl LUCIE COUNTY, FtORIDA:
Th~s ~s my dedarahon of Dom~c~le and Citizenship in the State of Florida that 1 am f~l~ng this day ~n accordance and
~n conformity w;th Chapter 222, Se:t~on 222.17, Florida Statutes
1 was formerly a legal resident of New York C1ty ~EW YQ2'k
(City) (State)
anc~ 1 resided at ~575 Palisades AVe.. _ However I have cha~ged my domiG":R
(Street and Number)
~o and am and have been a bona fide resident of the State of Florida s~nce ~th day of
Sept , 19 70, and 1 ~eside a~ 1110 b~atiyfaiT Lane Port St. Lucie
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement ~s 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 business, or relinquishment oF employment
- ~t former domicite, removal of family to new domicile, purchase of home, etc.)
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Establishing residence
=F~~p`~AND RE~R
S7. l.UC1E COUN ~ Ep
R£CORD VER
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~ ~~0 SEP 22 P~ 2: qe
__.~~-d~ RAS
ROGER PO~T
CLERK CIRCUII COURTJ ;
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~ 1 FURTHER CERTIFY that I will comply with all oiher requirements of a lega) resident af this State. ~
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I FURTHER CERTIFY that I have no intention to return to my former domiCile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_
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' ' ' f ~ ' Souis ' . Sqlomon ~
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~ ~,~iexa~ty~ w i f e
~~pe . T`i? .
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~ •1~•• Esther Solo~on
~ . C ~Y ! y.
~ 5w~m to'~ihd subscribed before me this - _ 2221~ _ _ _ day of _ ~g~ ~ ~m~ ~T 19___~4
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~ R ER POITR/1S - - - - - - -
_ K CIRCUI~ COURT Notary Public
g--- s~..C_c_ c: _ ~C_"~"'- _ D.~. My Commission expires - - -
(Te b~ ~x~c~t~d in duplic~t~ and oripinal filad w~tl~ Cl~lc G?c~it CouA, and duplicaf~ wifl~ Tax Assassor.)
gooK187 Pa~ 628 =