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HomeMy WebLinkAbout1486 i Deciaration ot Don~iCile and Citizenship TO THE STATE AND COUNTY TAX ASSESSOR, ~i':73~;3 il. IUCIE COUNTY, FlC'RIDA This ~s my dedaration ot Dom~ule an~ Citizenship in the Stete of Florida that 1 am fil~ng this day in accordance and n conformity with Chapter 222, Sectio~ 222.17, Florida Statutes i~alveston :exa~ ~ was formerly a legal resident of . ~~;fy~ (State) and 1 res~ded at 1~1~ Ave~.u~ g y Nowever I have chan ed m domitile (Street and Number) ~o and em and have been a b~na fide resident of the State of Florida since OC t0 DeZ' S day of 3203 Tennessee Ave • , 1970 , anc I reside at _ _ - (Street and Number) FORT PIERCE, SAINT IUCIE ZOI~NTY, FLORIpA yr,d th~s statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida. (Insert here any pert~nent facts, such as sale of property or business, or relinquishment of employment at former domicile, removal of family to new domicile, purchase_of home, etc.) _ FI~EO AND RECORD~D~ ~.arvin Craig, III ST. ~UCIE COUNTY, FL'A.' c~~coRn v~~iFrFo 1~~3~;3 ~ , 'TO OCT 6 AN 8: 57 , RO~ER ?OITRAS CLERK CIRCUIT COURT.~ ~ f f ~ I ~ : E i t : ~ ~ ~ ~ 1 FURTHER CERTIFY that I will comply with all ofher requiremenis of a legal resident of this Siate. r 1 FURTHER CERTIFY that I have no intentio~ to return to my former domic,ile, and 1 intend to remain in FORT ~~FRCE, SAif~lT LUCIE COUNTY, FLORIDA, F~ermanently. ~ • ~ ~ ~ r~ -,r L / - ~ ~,;.~i~:~if:i:~~;,. _ ~ e~ -Beverly Teitsort ~ •'~~-~~'~:C~t~, ~ f „ ; ~ ~ gZ.~~" i 'Q O ~ : - - - ',tr, ~i f ; G ~ (Addressl ~ .f ' ' ~ . ~ l~~~' •.ksubscritsed before me this -fiY.l1___-- da of -_.~_~4~22~T_--. , 19~Q_. ~ ti ~ , ~ ~~fi~ - Y ~ . 1 E~e.~~.. ~ lOG~R 'OITR/1S - ~ CLERK GRCUIT UR ~ Notary Public ~ ~ / ~ 8y ~ u_-__ ~.C. My Commission expires ~ ~ ~ c J (To b~ ~x~cvt~d in dupliut~ and orisinal fil~d with Gtrk Circuit Cou~f, a~d dupliut~ with Tax Ass~s:or.) ~ ~ ~a BOR~ ~ +'A1,~ ~4~U . . ~ ~ . _ = - ~ ~ ~ : :