HomeMy WebLinkAbout2145 De~laration ot ~omicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, a~J~3
51. lUC1E COUNTY, FIORIDA.
This is my detlaration of ~omiule and Citizensh~p in the State of Florida that 1 am filing this day in accordance and {
~n conformity with Chapte~ Section 222.17, Florida Statutes.
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I was formerly a legal resident of ~~ka ~i~~-
(City) (State)
and I resided at 2829 Euclid AV@• _ However 1 have changed my domiCile
(Street and Numbe~)
?o and am and have been a bona fide resident of the State of Florida since 6t~1 day of
1~arCh ,~9_?1 , and I res~de atTemp• s 190 Isl Sf to _ ~
(Street and Number) ;
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f~RT PIERCE, SAINT LUCiE COUNTY, RORIDA
and this statement is to be taken as my declarasion 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 employme~t
at former domicile, removal of family to new domicile, purchase of home, etc.)
Entering ehildren in school '2C`~593
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ROCER POITRA=
CIERK CIRCUIT COURT
- RECORD YER~~IEO~.,~.~
M~r ~ 11 ~3 PM't i
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~ 1 fURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
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t FURTHER CERTIFY that I have no intention to return to my former domiule, and I infend to remain in FORT
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~ PIERCF, $AiNT IUCI~-COUNTY, FLORIDA, permanently.
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~ ' ` - .r?~' . (Name)
~ _ R . ~ . _ John g. l~ercer
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• ' . s• (Address)
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' Swom to and{s~bscribed before me this 8th day of _~arCb , 19 71
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ROGER POITRAS - - -
~ IPRK CIRCUIT COURT Notary Public ;
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~ By _ _ D.C. My Commission expires ~ ~
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~y (To b~ ~xecuted in duplicate and original filed witl~ CI~?k Grcuit Court, and dupliuts with Tax Ass~ssor.)
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