HomeMy WebLinkAbout1315 O~claratlo~ ot Doml~lla a~d Citl:~nshlp
TO THE STATE AN~ COUNTY TAX I155ESSOR, •
51. lUC1E COUNTY, FIORIDA:
This is my declaration of Oomicile •nd Citiser~ihip in tM Stat~ of Florid~ that 1~m filin~ thit day in ~coordano~ ~nd
~n conformity with Chapte? 222, Section 222.17, Florida St~tutet.
I was formerly s teqal resident of ~"~~~~Q~~ _
(~ity.) (S1ah)
- ~ /
and I resided at ~5~. ~ 7 -l~~ l~~ . Hovwver 1 have charped my domitile
(Street and Numbery
to and am and have been a bona fide rosident of the Staro of Florida sinoe ~!'I~S~~~ 7~~~,D .day of
oy~ -
- , 19 , and I roside at
(Strset snd Number)
FORT NERtl, SAINT LUt1E COUNTY, RORtDA ~
and this stateme~t is to be taken as my declaration of citizenship, sctual legal residence and domicile in ihe State of Flotida.
(Inse~t here any pe~tinent facts, such as sale of property or busineu, or relinquishment of employment
at former domicile, removal of famity to new domicile, purchase of home, etcJ
~ ~
~
~03211.
sTLED ~kD ~ECO/t~
WCIE Cp j~n
CtE~~fR
RECORD Y~q~
~ ~T
~ it ~~59~
lt ~
;
~
` C~
i ~
~
~
F
~
e
~
~ 1 RJRTHEit CERTIFY that 1 will oomply with all other requirem~nb of a lepsl reiident of thi: State.
I FURTHER GERTIFY that I have no +ntention to retum to my former domiCile, and I intend to remain in FORT
PIERCE, SAMIT LUCIE COUNTY, FLORIDA, permanently. ~
_ ` .
`~~~?<<~„~~~„~,,~ - r
` y 1?~~,~`,",,.; yYw /1/ s ~/j/
~ ~ ~i ' ••,J~: : (Na )
' ' ~ ~ ' . John D~art~nson
^ ~i - ~
: s~-i .
. .•-'~,~e`~,~
_ ; . ~
~ .
~ = L a : _ (Addres:)
. - ~ • . :
. _ . i
-s ! - • 1.
C~~:. 4c;,,~~..~.:.~ lltr. January ?1
'~~'~+~•~.t~kg~n`ip-and subxribed before me ihis day of , 19 .
ROGER rORRAS
CIRCUIT OURT Notary Public
By D.C. My Commission expires
Re b~ ~x~evtrd in duplkal~ and eriotnsl !il~d whb CIw1c Ci~arif Ce~e1, ~ed duplkah wid~ Tax A~w,?
, ~ bGCK PACE ~J~
~y.
; > , , - ~ ~cy,~~
- ~~~"y :~-a
~ ~,~~~-.~-~c ~ . ~ _