HomeMy WebLinkAbout1424 Declaration ot Oomicile and Citise~ship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FIORiDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
~n conformity with Chapter 222, Section 222.1?, Florida Statutes.
I was forme~ly a legal resident of Cli~on New Ybrk `
(Ciy) (State)
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and I resided at 28 H~~11to11 PLCe _ However ! have changed my domiCile ~
(Street and Number) ?
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!a and am and have been a bona fide resident of the State of Florida since 1~y 15 _ day of
_ , 19~~ , and I reside at __T~ $plu ~i~~__
Folt Pi~]!'oe, Fls• (Street and Numbe~)
FORT PIERCE, SAINT WCIE COUNTY, FLORIGd _
and this statement is to be taken as my ~eclaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as saie of prope~ty or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, ett.)
Estsblishins residenoy ior Loaestsad ~ze~p~ioa
FILEO~AND~ RECORDEO~p
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j ROGER POITRAS
C CLERK CIRCUIT COUR7]
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I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State. i
I FURTHER CERTIFY that I have no intention to return to my former domicrle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanentiy.
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_ . ~ _ _ ~ _ _t L'~. ~
~ (Name) , ganneth Haalia
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- `'~~f,+~r,prlif~i~tltbscribed before me this -_-s~h day of ~t~hlr- 19 70
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. ~ CUI~ pURT Notary Public
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~ gy . U.C. My Commission expires .
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(To b~ ~x~cuMd in duplicat~ and oriQinal filsd with Cl~rk CircuH Couef, and dupliut~ with Tax Ass~ssor.)
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