HomeMy WebLinkAbout1366 20324~
tkcia~atto~ of Domicil• a~d Citis~~ship ~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. tUC1E COUNTY, FIORIDA: ~
This is my declaration of Domicile and Citi:enship in the State of Floride that 1 am filin~ this d~y in aooordano~ and
in conformity with Chapter 222, Sectio~ 222.17. Florida Stetutes.
I was fo~merly a legal ~esident of _
- ity) tste)
and 1 resided at ~9~" ~ G~~ However 1 have cha~psd my domic3le
- ~ (Street and Number)
to and am and have been a bona fide ~esident of the State of Flwida sinoe ~3 dsy of
, 19,~, and 1 reside at 2'
(Sheet and Number)
FORT lIERCE, 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 Horida.
(Insert here any pertinent fads, such as sale of ~operty or busineu, or relinquishment of employme~t
at former domicile, removal of family to naw domicile, purchase of home, etc.)
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2~3249
FllEO AN~ RECORoto
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a~R~ c+~cwt aow~t
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,Ja~ It 4 u P!!'TI
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~ 1 RIRTHER CERTIFY that 1 wil) oomply with all other requi~emenb of a la~al resident of this State.
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I FURTHER CERTIFY that I have no intention to return to my former domivle, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. FZ'Bllk R. Callihan
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(Name)
a
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~ 2 ~ Q.t.ll/Y~O~p~- O'~ !i ~ .
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~ Swq?Q_to and suburibed before me this 12th ' day of J~~arY ~ ~q ?1
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~ ~~~~NU~.~.
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~ t~` ' . 5 ; l.-~
~ ~ Notary Public
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~ gY ' ~ D.C. My Commission expires
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~ ''t,•"~ : ;t~' -
i,y~~r . ~i~ r
~ii / . ~ 4 . .
~ ~T'd,~r ~~+~,~bpHcab and o~inal Al~d whb CINIc qrsei~ Courf, and duplicah with Tax A~~.j
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g: int~t~~1~~~~-. .
~ QOOK 1v~ PACE~~ -
~ No. 11 . _
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