HomeMy WebLinkAbout2345 Declaration ot Domicile a~d Citizenship
TO 7HE STATE A(hD COUNTY TAX ASSESSOR, 2~n~
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Sl. LUGE COUNTY, FIORIDA~
This ~s my declaration of Dom~uie and Cit~zenship in the Stare of Florida that I am fili~g this day in actordance and
~n conformity w~th Chapter 222, Section 222.17, Florida Statutes.
i was formeriy a lega) res~dent of ____.SQringf i el d ~Q ~ S S.
(City) (State)
and 1 resided at _ 12?4_ W1ibTl~hHID A`Ie.__ . However 1 have cha~ged my domicale
(Street and Number)
ro and am anci have bee~ a bona fide resident of the State of Florida since ~Ct . 1 day of
_ _ _ _ ~9_71, ar~d i reside a~ 1166 BeyRrore Drioe .
(St~eet and Number)
Ft. Pierce, Fla.
FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA
and this statement is to be taken as my deciaration of citizenship. adual legal ~esidence and domicile in the State of Florida.
(Insert here any pertinent fads, such as sale of property or business, or re:inquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) .
sT l C E COUMTY fu
Estnbliahin - reainency ROCER POITRAS s
CLERK CIRCUlT COURT
RECORD YEqIFIED ~ ~
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
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I FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT
~ PIERCE, SAINT LUCiE COUNTY, FLORIDA, permanently.
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- . ti (Name) Charle . R~an
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Ma y l~. Ryan
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_ Swocn to and subscnbed before me this gtr~ day of Deeember ~ ~9 71
- • . ROGE~t PO.IT~IS
" CLf.RK CIRC R COURT Notary Public
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- By ' O.C. My Commission expires
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' (To bs executed in duplicate and origina) filed with Clerk Grcuit Court, and duplicate with Tax Auessor.)
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