HomeMy WebLinkAbout0810 i
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D~claratio~ ot Doml~lie and Citis~nship
TO THE STATE AN~ COUNTY TAX ASSESSOR,
Sl. lUCIE COUNTY, FlOR1~A: ~
This is my declaration of Domicile and CitiZenship in the State of Flo~ida that 1 am filinfl this day in accordsnce and
~n co~formity with Chapter Z22, Section 222.17, Flo~ida Statutes.
I was formerly a legat res~dent of Spartenbur~ SO Carolina _ ~
(City) (State) ~
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and 1 resided at _ R F__D ~ 7 However I have changed my domicjle ~
(Streef and Number)
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to and am and have been a bona fide resident of the State of Florida since 1st dsy of
January , 19.~Q, and I reside at R F D 4 BOZ 273 Edwards Rd
(Street and Number)
FORT MERCE, SAINT LUCIE COUNTY, FtORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, suth as sale of property or business, or relinquishment of employment
at forme~ domicile, removal of family to new domicile, purchase of home, etc.)
Establishing residence~snd applying for homestead
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; I FURTHER CERTIFY that I will comply with all other requirements of e leyal resident of this State.
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' 1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
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~ PIERCE, SAINT ~UCIE COUNTY, FLORIDA, permanently.
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~ ~ ~ ~ ~ ~ (Name)
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; - r,,-"•. _ Jamea Davis .
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$ = 'k~~. Luc ille I~avis
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g '~i~t ~o and subscribed betore me this 4~ day of J~u~3~ , 19 ?1 .
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x ROGER rORRAS
~ CIRCU T COURT Notary Public
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~ gy ~ ~~-t~G~i p.C. My ~ommission expires
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(To b~ uacut~d ie dupllcat~ and ori~inal Al~d wilh CIKk Grarh Couut, and duplicat~ with Tax Atw~.)
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R eo~K1$9 P~ 807
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