HomeMy WebLinkAbout1097 N'
Declaration ot Domicile and Cittzenshlp
~
TO THE STATE AND COUNTY TAX ASSESSOR, ~
~~8 `
Sl. LUCIE COUNTY, FLORICA
yk
1
This ~s my declaration of ~om~cile and Citizenship in the State of Florida that 1 am filing this day in accordance and <
3
~n conform~ty w~th Chapter 222, Section 222.17, Florida Statutes. ~
.
t
ADG~R ALABAMA ~
I was formerly a legal resident of _ `
- - - - - - - ~
~C;y~ (State) ~
~
and I resided at _ Rt . BOX _'S05B_ _ However I have changed my domic.ile ~
(Street and Numbe~) i
,
~ t
ro and am and have been a bona fide resident of the State of Florida since ~ 5th _ day of ~
t
Decenber 19_?~_, and I reside at __602A Wisteria Aoe. , Ft._Pierce L Fla. ;
(Street a~d Number) 33450 ~
FOftT PIERCE, SAINT LUCIE COUNTY, RORIDA ~
_
and this statement ?s to be taken as my declaration of citizenship, adual legal ~esidence and domicile in the State of Florida. ~
(Inse~t here any pertinent fads, such as sale of property or business, or relinquishme~t of employment
at former domicile, remova! of famiiy to new domicile, purchase of home, etc.) ~
1
v ~ c T r~un ~
?IILN N14 f~lvYnVLr •
ST. LUCI~ LOUMTY FU. ~
ROCE i PDITRAS
CIEk!. Cc~GUIT COtlRT '
AfCORD YfR~F1E0
~
~ ~C ~ 2 13 ~~'Z ~
e
~
~
~ 221208
:
~ ~
,
£ ~
~ j
~ ;
~ ~
~ 1 FURTHER CERTIFY that 1 will comply with all other requirements of a leyal resident of this State.
~
~
~ I FURTHER CERTIFY that I have no intention'to return to my former domiGle, and I intend to remain in FORT
~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. J~~2'G ,i1f
a , ~,Gl
~ GERALD A JOHNSON
~ ...~.Y , ( ame)
~ - ~ i~
: •
1
~ 602A Wisteria Ave., Ft. Pierce,Fla.
. • r, -
. - . . (Address) 33450
_ . ~ 'r ~
~ • . . • • ~•y~ ~ `
Cy~.to'pnd subscribed before me this 29th day of December ~~q ?1 . 9
~ ! s ~ ~ ~
• •
- ROGER POITRAS ~
C CUIT COUgT Notary Public ~
~
ey D.C_ My Commission expires
k~~
~z:
~fi (To b~ ~x~cuted in dupliute ar~d oripinal filed witl~ Ge~lc G~wit Cou~, snd dupliut~ with Tax Assfssor.)
$01111 Y~Gt~~
` *:a 13
, _
-
_ , ~'r . ~ : =-f=~;