HomeMy WebLinkAbout0774 Deciaration ot Domicile a~d Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Domlcile and Citizenship in the State of Florida that I am filing this day i~ accordance and
~n conformity with Chapter ?22, Section ?22.17, Florida Statutes.
I was formerly a legal resident of . _ ~ ~?1 _ _ .
Ci - `~U Stete -
( tY) ( )
and I resided at ~ ~-t-lae'^~ '
I_~ However 1 have changed my domi~ile ?
(Street and Number)
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to and am and have been a bona fide resident of the State of Florida since __~i-~t~-~____ day of
- ~c'c'~~~' v - - - 191~ , and I reside at _ ~
-2i ~ ?Z~- 3 3 ( Z t~, 7T.~s-`c~i C C! - - -
(Street a~d Numbe~)
FORT PIERCE, SAIN? LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
.
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FILEO ANC HECOROEO
ST.IUC+E CQUMTIf flA.
ROCER POtij~s
CIEaK C~RCUIt COUR?
RECORO YERIFIEO~~
` FE817 21z PM'TI
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~ I FURTHER CERTIFY that I will comply with all other requirements of a lega) resident of this State.
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I FURTNER CERTlFY that I have no intention to return to my former domi~ile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ at ~..u hL~~o-~.~.-a-,..~
~ i~1 ~C~ ame) Dot~ald James McGowan
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E ~ ;o~and subscr~bed before me this - day of - , 19
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- R06ER POITRAS
~bR K CiRCU1T COURT Notary Public
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By D.C. My Commission expires s
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~ (To b~ ~xscut~d in duplical~ and oripin~l ~iled with Ct~rk Circ~it Court, and duplicat~ with Tax Ass~stor.)
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