HomeMy WebLinkAbout2072 r
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Declaration of DomiCile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA
This ~s my declaration of Dom~cile and Citizensh~p in the State of Flo:ida that 1 am fiiing this day in accordance and `
~n conformity with Chapter 222, Section 222.17, Florida Statutes. ~
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I was formerly a I~gal resident of West Carrollton _ Ohio '
(City) (State) ~
214 Ironwood Drive
and I resided at _ . _ . . _ _ _ _ _ _ However I have changed my aomi~ile
(Street and Number}
!o and am ar.d have been a bona fide resident of the State of Fbrida since 18th _ _ day of
. Septemb~r , i9__ 74, and I reside at _884. _S.W ._Solaz Ave. , Port St. Luc ie
(Street and Number)
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.
(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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residence gT~~u~ EN~O ECORDEO~j
~~CC?Rp ~UNTY~ F~A~,
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p 19~%$~
OCt 16 AM 9 : ?9
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II ~ ~rRAS
' ~~ERK CIRCUf7 CDURT~
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~ I FUR7HER CERTIFY that I will comply with all other requirements of a legal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domiule, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently_ -
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~ ~ ROBERT J
~ - ~ me)
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' 884 S.N. Solaz Ave., Pt. St. Lucie
~ ~\`~,t:~t~~r:r~~~,! - - - -
~ ,~~;•.,.~;~t; C (Add~es5)gort Pierce, Fla. 33450
~ ~o. 0
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~ ~ ` ' 16th October ?0
~r,s~~s'cribed before me this day of , 19
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`A c~ ~ .
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~ ~rir~a~
~ ~.~~,w~~~ ~RT Notary Public ~
~ l E C~ ,
~ 8y ~l~r~ ~ D.C. My Commission expi~es
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(To b~ ~x~cuhd in duplicsN and ori~inal fil~d with Cl~rk Grcuit Court, and duplicats with Tax Ass~ssor.)
400~ i8? ~E 2072
No. 13 - •
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