HomeMy WebLinkAbout0098 ~:i.avv~ ti ~
D~clara~ion ot D~micei~ an~ ~itizcn~~~i~
TO TNE STATE AND COIiNTY TAX ASSESSOR,
~l. IU~IE COUNTY, FlOR10A: ,
This ~s my declaration of Domicile and Cit~zenship in the State of Fiorida that I am fil~ng this day in accordance and
~n coniormi:y w~rh Chapter 222, Sect~on 222.17, Flo~ida Statutes.
1 was formeriy a legaf resida~t of __-~'IQ~_~-__-_ __~~4~~ -
(City) (State)
12C titi'eat ropler Street
and t res~ded at _ _ _ _ _ However I have changed my domiCGle
(Street and Number)
' April 30
ro and am an~ ~ ove ~CCl1 a bona Tide resident of the State of Florida since _ day of
- - 19_71 , and I reside ar _~~ergladea Bl~d. - g3Y=7e~ - -
$tLi82't Fllt . (S~reet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~Beeu ~ivage) house located in St. I,ucie Co.
and this statement is to be taken as my detlaration of citizenship, actuai fegal res+ocnce and domicile in the Ssate of Florida.
(Insert nere any pertinent facts, such as sale of properiy or business, or relinquishment of emp:oymens
at former domicile, removal of fami{y to new domicile, purchase of home, etc.)
~atabliahing reaidenc~ and citizen~hip in St. Luci ounty, Fla.
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i FURTH:R CER7tF1( that I will comply with ai! other requirements of a legal reside~t of this Staie.
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~ t FURTri~R CERT~FY that I have no iniention to return to iny former domiU;e, and 1 intend to rsmain in FORT
~~tRCE, SAINT L'aJCIE COUNTY, FlOR10A, ~e~manentiy.
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( ame) Rudolph A. Brodman
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(Address)
Sworn so ar.d subscr~oed Cefore me this lp day of NOrembel'________ , 19~_.
ROGER POIt1;A5 - _ _ _ ~
LERK C}RWIT C URT , Notary P~bi;c ~
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~ By ~ ~ D.C. My Commission exp~res ~
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~ (To ~ exec~ted in duplicate and ori~inal filad with Uerk Circuit Court, and duplicate with Tax Assessor.) ` :
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