HomeMy WebLinkAbout1405 i
~eclaration ot Domicile and CitOzenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNIY, FIORIDA
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This is my declaration of Domicile and Citizensh~p in the State of Florida that I am filing this day in accordance and
~n conformity with Chapter 222, Section 224.17, Florida Statutes.
I was f~rmerly a leg~l resident of ~eW YOY'k Cf t3/ _ N Y
(~ity) (State)
and 1 resided at 39-65 52nd street Woodside
_ _ _ _ _ However 1 have changed my domiCile
(Street and Number)
!o and am and have been a bona fide ~esident of the State of Florida since ~5th _ day of
September , 19_?0 , and I reside ar 1108 North 39th street
(Street and Number)
FORT PIFRCE, SAINT LUCIE COUNTY, FLORIDA
an~ this statement is to be taken as my declaratio~ of citi~enship, actual fegal residence and domicile in the State of Florida.
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(Insert here any pertinent fatts, such as sale of property or business, or relinquishment of employment :
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at former domicile, removal of family to new domicile, purchase of home, etc.) ~
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~stablishing residence and will apply for homestead ~
F~i.~o ~aNO ~ RECORO~o~~.
ST,RECORO VERTF EpLA.
1992~'7 `
'TO OCT S AN 1: 26 ~
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RQGER r'OI7RAS
CLERK CIFtCU1T COURTj
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~ 1 FURTHER CERTIFY lhat 1 will comply with all other requirements of a lega) resident of this Siate.
I FURTHER CERTIFY that I have no intention to return to my former domiGle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permane~tly.
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. ~ ard l~ler
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~ , " ~ ~ " ~ p~rliss) - - 4
~ ~ Jane ~Ciller ;
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~ Sw~o~n tb: e~d subscribed before me thia day of OC tO b e T , ~ 9 70 ;
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~ OGER POITRAS - -
~ K CIRCUIT COURT Notary Public
~ B ~ `-~t~~ _ _ _ D.C. My Commission expires
(To b~ ~XKY1ld in dupliuts and oripinal fil~d with Cl~rk Circuit• Cour1, and dupliut~ with Tax Ass~ssor.)
„ ~ gQOK 187 PA6E 1405
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