HomeMy WebLinkAbout1822 i
Declaration of Domicile a~d Citisenship 1~~•5g1
TO THE STATE AND COUNTY TAX A~SESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domiciie and Citizenship in the State of Florida that 1 am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Flotida Statutes. ~
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I was formerly a legal resident of _ BOtd@II____ 111(~18II8 ~
~L;Ty~ (State) r
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a~~d I resided at R F. D 2 - 9 Y {
However I have chan ed m domicile ~
(Street and Number) }
ro and am and have been a bona fide resident of the State of Florida since 3rd _ day of
October , 19 , and I reside at 386 Basinger Av~.
(Street and Numher)
F~RT PIERCE, SAINT lUC1E COUNTY, FtORIDA
and this statement is to be taken as my declaration of citizen'ship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or ~usiness, or relinquishment of employment
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at former domicile, removal of famity to new domicile, purchase of home, elc.)
Entering Rodney J. in the 6th grade ~
Michael in the llth grade `fILEO AND RECOROE01 =
ST. LUCIE COUNTY. FLA. ~
RFCOR7 1~'~RIrIFO
" Merlin in ~he 12th grade 1~~ j~~'
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Marilyn in the 12th grad~ 'TO OCT ~ 2 ~ 9% s
ROGER r ITRAS
~ CLERK CIRCISIT COURT~
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. ±
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I FURTHER C~ERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently. ,
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~`•'~p 12th October
'Swpr~'~lMO~~aAil subscribe~ before me this _ day of _ _ . , 19
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~
OGER POlTRAS
~ LERK CIRCUIT COURT Notary Public ~
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~ D.C. My Commission expires
(To bs ~x~cut~cl in duplicat~ and oriqinsl fil~d witl~ CIKk Gnui! GouM, and dupliut~ with Tax Asses~or.)
BURF:107 PAGE~H~
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