HomeMy WebLinkAbout2252 Qeclaration ot Domicile a~d Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~71~
51. IUCIE COUNTY, FIORIDA: V~
Th~s ~s my declaration of Oom~c,le and Citizenship in the State of Flo~ida that Lam filing this day in acco~dante snd
~n confo~mity with Chapter 2?~, Settion 222.17, Florida Statutes. `
1 was formerly a legal resident of _DetrO~t _ _ _ _ ~~Ch_
~g~11
(Ciy) (State) ;
and 1 resided at _ 16510 St9@Z• A~e11L19.______ Fbwever 1 have cha~ged my domiGile
t
(Street and Numbe~)
ro and am and have been a bona fide resident of the Stste ~f Florida since _ __25th. day of
_ _ _ _ Qctober ~9_?~ and I ~es~de ar 612
~each A~enue, River~~~ _
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA
and this statement is to be taken as my declarotion of citizenship, actual legal ~esidence and domicile in the State of Fbrida.
(Insert here any pertinent fads, such as sale of property or business, or .•elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
For fiomeetead -
~115~3
FtLE~ ~MO RECOROEO
Sj LUCIE COUMTI? FlA
RaCER FOITR~~
CLERK CI~CUIT C9UR
RECORD VERIFIED
~tll 7 IO 53 ~M'~ 1
;
I FURTHER CERTlFY that 1 will oomply with al) other requiremenis of a(s~a) resident of this State.
I FURTHER CERTIFY thai I have no intention to return to my former domicjle, and t intend to remain in FORT
PIERCE, SAINj;tHCj~''CQUNTY, FLORIDA, permanently_ 1COla Y8CI~6Hri
. . ' _ , ~ l
. , " _ ~
~ ~ _ (Name)
_ . - -
= _ •
612 Beach Avenue~ Fort Pierce, F18
~ C~~~; - " (Address) ~
Sworn to and subxribed before me this ~th dsy of - Ju~ , 19_~_
ROGER POITRAS _ _
CLERK C:RCUIT COURT Notary Public "
8~• ~~~--1!3~u~`'```~ D.C. My Commission expires
(Te b~ ~x«ut~d ie duplicat~ ~nd ori9inal fil~d witb Cl~rlc GrwN Gour~, and dvplicst~ witl~ Tax AsMS+or.)
~ » so~K 193 2250