HomeMy WebLinkAbout0770 D~cla~ation ot Domlcll• and Citis~~ship 2~~~~
TO YHE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE ~OUNTY, FIQRIDA:
This is my decls~ation of Oom~cile and Citi:enship in the State of Flo~ids that 1 am filin9 this dsy in ecoo~dance and
~n conformity with Chapter 222, Section ~22.17, Florida Statutes.
~ ' y~ ~
I was formerly a legal resident of ~ ~ ~~.~a~
(CiN) (Stsh)
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and I resided at _ 3__ 1t ~~/_G--~ However I hsve chanyed my domicjle
(Street and Numbe~)
to and am a~d have been a bona fide ~esident of the State of Flo?ida since _~.2~!:~S ' ~ day of
- - _ 19.~~, and I reside at ~G (-t ~~o? /_~L~--~_
(Sireet and~uN mber)
FORT PIERCE, SAINT WGIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence arid domitile in the State of Florida.
(Insert here any pertinent fatts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.) ,
~~~~?L~_
202838
f IlEO ~ND AECOR~EO
~IOM+~~E
~PO
TI
AS~~
RECORD YERI~ftEO C T
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~ 1 FURTHER CERTIFY that 1 wil) com I with al) other r uirements of a(
p Y eq eyal resident of this State.
f FURTHER CERTIFY ihat 1 have no intention to return to my former domiCile, and I intend to remain in FORT
PlERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ _ / .
~ - ~ ERNEST J . R~GHT
~ `te~~111N/lt?iIr ~
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~ , L7~.•~~~J. , ~ C~';~ ' (Address)
2 ' s~ fG
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~ N-~ojA~fq, q~ ,~scr$xd before me this day of ,~q ~
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~ ~'Q~h~~~T Notary Public
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~ BY D.C. My Commission expires
1To b~ ~x~cvt~d in dvplicaN and eriqina! Rl~d wilh Clak Grcuit Court, and duplicalr with Tax AsMS~or.)
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~ s~AK 189 ~~r.~E .768
Mo 13
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