HomeMy WebLinkAbout1836 O~claratio~ ot Domi~il• a~d Citit~nship 201~~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FlORiOA: ~
This is my declaration of Domicile and Citizenship in the State of Florida that I am filiny this day in aooo~dance and
in oo~formity with Chapter 222, Section 222.17, Florida Statutes. ~ _
I was forma~ly a legal resident of Rochester ~ _ Hew York
(City) (51ate)
and i resided at _102 CBm~iLie Drive ~Wever I have changed my domic~le
(St~eet and Number)
to and am and have been a bona fide resident of the State of Florida since OC tOb eY' 17 day of
_ , 19?~ , and 1 reiide at 1008 $OUth 7th 3tTeet
(Street and Number)
FORT M~CE. SAINT IUCIE COUNTY, RORIOA
and this statement is to be taken as my declaration of citizenship, actval legal residence and domicile in the Stare of Florida. .
(Inse~t here any pertinent facts, such as sale of property or business, or ~elinquishment of employment
~at fo~mer damicile, removal of family to new domicile, purchase of home. str~. _
Establishing residency
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1 FURTHER CERTIFY that 1 will comply with all other requirsments of a lepsl resident of this State.
I FURTHER CERTIFY that I have no intention to retum to my former domitile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORI~A, permanently.
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~ ~ (Name) Jack J . Bz'yne
~
~ (Address)
~~o~?.,~,~nd wbt4ribed before me this 1st day of DeCembeT ~~q 70.
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9y= ~ u .C. My Commiuion expires
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