HomeMy WebLinkAbout2940 206236
Oeclaration ot Domicile and Citi:enship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FIORIDA:
This is my declaration of Dom~cile and Citizenship in the State of Florida that I am filing this day in accordance and ~
~n conformity with Chapter 222, Section 222.17, Florida Statutes. i
I was formerly a iegal resident of princQtOYI_ _ _ gQIItL1C~C~___
(City) (State)
and I ~esided at _ 9fQ~.8Y1 Dt~VB _ However I have changed my domiule
(Street and Number)
{
to and am and have been a bona fide resident of the State of Florida since 1st _ . day of
i
~
August ~9 70 , and I?es~de at ~511 Cheste7~'field Drive ~
~ (Street and Number) {
t
FORT PIERCE, SAINT tUG1E COUNtY, FLORIDA
artd this statement is to be taken as my declaration of citiZenship, actual legal residence and domicite in the State of Florida. ~
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at farmer domicile, removal of family to new domicile, purchase of home, etc.) ~
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Homeatead ~
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Residence
206236
~~ED ANO A~~pR
ST.111C~E COUMT1r ~
~
CtERI~ C R UIT
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RECORO YfRIF1Ed T
' ~ ~s 413 Ply'
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~ _
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~ I FURTHER CERTIFY that I will compty with all other requirements of a legal resident of this State.
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~ I FURTHER CERTIFY that 1 have no intention to return to my former domiGle, and 1 intend to remain in FORT
~ PlERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~y'~
~
~ ANTHOBY ALLO
+ ' ~ r i i s ~ . - - -
~ ; J~ ~ (Name)
~ ~ r C/
~ J : ~jJ
~ . a ~ : r `;i ' y i.
$ : ~ ~ 2511 Chesterfield Drive Ft. Pierce
Y _ :i . , p. f f
W-~ - = ~ J - -
~ = ~ - ~ ~ ~ (Address) '
~ .
: - ° ; : , : ` 33450 a ~
• ; . :
' ' ~ ~ ~ :
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~ • ~ ~ :
~ ~S~pTo~rs~~~Nbxribed before me this -__16th day of ___Y8Z'Ch _ _ ~ 1971 _ ~
` r; ";?yr~~z%~ .
~ - ' - ,
# ROGE~ POITRAS ~ - - '
~ C CIRCUIT COURT Notary Public
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By _ ~c1~ - D.C. My Commission expires
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~ (To b~ ~xscut~d in duplicat~ and oripinal ~iled whh Cl~rlc Circuit Court, and dupliuts with Tax Ass~s~or.)
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BORK 1c70
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~~S_~ws _ ' C~^. d ~"'~',Y_