HomeMy WebLinkAbout0057 Q
DeclBration ot Domicile and Citizenship ~25~8
TO THE STA~E AND COUNTY TAX ASSESSOR,
51. WCIE COUNtY, FIORIDA
Th~s ~s my declaration of Domiule and G+tizenship in the Sta~e of Florida that I am f~ling this day in accordance and
~n co~formity with Chapter 222, Section ?~2.17, F!orida Statutes.
~ was formerty a legal resident of TCZEDO OHIO
~C;ty~ (State)
and 1 resided at 3203 Goddard Rd _ However I have changed my domi~ile
(Street and Number)
'o and am and have been a bona fide resident of the State of Florida since 5th - _ d~y Q+
Na~enber 9?'1 , and I reside ar ~ 7~ N. E. Penlynn A~e_~__No . Pt . St .
~ (Street and Number) Zuc i e
FORT PIERCE, 3AINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert 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.)
RESIDENCE f~LEO a?~p
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~ 1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
~ 1 FURTHER CERTIFY that I have no intention to return to my former domiule, and I intend to remain in FORT
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~N
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j~ s' LESTER l~ . TROUTIRAN
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~ . .t ~ • (Name)
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~ 171 N. E. Penlynn Ave. , No. Pt. St.
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~ : _a ~ . ? Q'~ (Address) I,ucie, ~'le. 33450
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'~,~GCt ~ C~1`~~o and subscribed before me this -___24th _ da of ___January _ , ~q_ 72
- ~rir~1fYA Y
- ROGER POITRAS _ '
_ = RCUIT COURT Notary Public
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By ` _ n'~-~ D.C. My Commission expires
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(To be executed in duplicate and origins) filed with Clerk Circuit Couei, and duplicate with Tax Assessor.)
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