HomeMy WebLinkAbout1530 Declaratlon ot Domicile and Citisenship
TO THE STATE ANC COUNTY TAX ASSESSOR, _
51. lUC1E COUNTY, FIORIDA: . ~~`~~~0
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This ~s my declaration of Domici;e and Citizenship in the State of Florida that I am fil,ng this day in accordance and ~
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~n conf~rmity with Chapter 222, Section 222.17, Florida 5tatutes. ~
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I was formerly a legal reside~t of _ ~~euil _ _ - _ ~AL~~H-____- ~
~C;ty~ (State) ~
and 1 resided at Lon~Ueld1 CaoAdB_ However 1 have changed my domiCite
(Street and Number)
'o and am and have been a bona fide resident of the State of Florida since Oa~ober 4 _ _ day of
_ , 19.=p , and I reside at _ 240 _Andrews Iaae - - _ -
(Street and Number)
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fORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. :
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(Insert here any pertinent 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.)
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Ginet~e Raynand
FILED AND RECORD~EDA.
ST. 4i
uC 0 R C~ ~ r~TY f Q
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'T4 OCT 6 PM ~ ~ ~
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~iOGER ~0?TRI~SUR7'
CLERK C~RCUIT CO
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I FURTHER CERTIFY that 1 will comply with all other requirements of a legal residant of this St~te.
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1 FURTHER CERTIFY that I have no intention to return to my former domiule, and I intend to remain in FORT ~
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PiERCE, SAINT LUCIE COUNTY, FLORfDA, permanently.
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. (Name) y~,~~ y~Qel R~4ynaud
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(Address)
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~~~~~•i 6t6 October , 19 T~ !
a~e~ii1',~~d subscribed before me this day af .
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~ RT Notary Public
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; = ~ ~ " ~ D.C. My Commission expires
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(Te b~ ~x~cut~d in dupliut~ and ori~inal filed with Cl~rk Cirn+it Cour~, and dupliut~ witt~ Tax Ass~sfor.)
a~ 1~7 ~1530
No. 13 . . . .
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