HomeMy WebLinkAbout1919 . i
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Declaration ot Dom? ;11• and Citise~shlp
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TO THE STATE AND COUNTY TAX ASSESSOR, t
Sl. lUC1E COUNTY, FlOR10A: ~
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This is my declaralion of Domicile and Citizenship i~ the State of Florids Ihet I em filiny this day in sccordance and i
~n confo?mity with Chapter 22?, Section 2?2.17, Florida Statutes.
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1 wes formerly a legei residemt of ` ,,..6~~Zd~- ` . _ - - - - ~ v~ ~
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ity) (State)
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and 1 resided at ~ ~'y~_~____ _ . Howeve~ 1 have changed my domitile
(Street and Num6er)
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ta snd am and have been a bona fide resident of the State of Florida since _ day of
.
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~ _ ! _ ~ ~~~'L,,~ _ _ 19~~ and I reside at `T^' _ _ - - - - -
(Street and Numbe~)
~FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my decla~ation of citizenship, actual legal residence and domicile in the State of Florida.
(Inse~t here any pe~tinent fads, such as sale of propery or business, or relinquishme~t of emptoym~nt
at former domicile, removal of tamily to new domicile, purchase of home, etc.)
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ST
WC E COUMTY~~
ROCER p01TAA~
AE ORO VERIi1fp
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M~ur 2~ 9 02 ~M'll
2~19
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~ 1 FURTHER CHtTIFY that 1 will comply with all other requireme~ri of a teyal resident of this State.
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~ 1 FURTHER CERTIFY tfiat 1 have ra intention to return to my former domiCite, and 1 intend to ~emain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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~ rt'b a~subsuebed before me this day of 19~.
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~ ~ ~ ~OURT Notary Public
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~ 8r D.C. My Commission expires ~
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~ Re b~ ~x~cvhd in dupliuN and ori~in~l fil~d witb Cl~lc Grcuh Court, and duplicat~ with Tax Ass~ssor.)
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