HomeMy WebLinkAbout2712 ~e~iar~~ian ofi DomiCi~~ an~i Ci~izensi~ip
TO THE STATE AND COUNTY TAX A55ESSOR,
Sl. IUCiE COUNTY, FLORIDA~
This is my declaration of Domicile and Citizenship in the State of Fiorida that I am filing this day in actordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerl a le al resident of Pe~a'
Y 9 ~S''~9~ZjE $~1~ _ - - - -
(City) (State)
and 1 res~ded ar _ p• 0. Bo~[ 204
_ However 1 have changed my domiGle
(Street and Numbe~)
fo and am and have been a bona fide resident of the State of Florida since 2?th _ day of
December , 19_?l , and 1 reside at 341_ S. _E . Bayview Terrece
(Street a~d Number)
fORT PIERCE. SAtN? LUCIE COUNTY, fLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Fio~ida_
(I~sert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
. 222344
Establishing reaidence P(LEO AkD RECORDED
tT. IUCIC COUNTY F~A.
ROGLn =nitR~S
C! EkK C+~cCtltT COURT
RFCn~: v~" F.EO~__
J~N I~ 10 ~a AM'71 ,
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> I FURTHER CERTIFY that 1 will comply with all other requiremenis of a(egal resident of ihis State.
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~ I FURTHER CERTIFY fhat I have no intention to return to my former domi~ile, and 1 intend to ~emain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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. (Name)
~ ~ ~ Richard H lSiller
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. (Address)
Swom to and subscr~bed before me this lgth _ day of __!T~uBTy _ ~ 19 72
ROGER POITRAS -
CLER CIRCUIT COURT Notary Public
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By _ D.C. My Commission expires
(To bs exscuted in dupliute and original filed with Cle~lc Grcuit Cou~t, and dupliuf~ with Tax Aswssor.)
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