HomeMy WebLinkAbout1464 Oeclaration ot Domicile and Citizenship
TO TNE STATE AND COUNTY TAX ASSESSOR. 223494 j
Sl. LUCIE COUNTY, FlORIOA:
~
,
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and ~
in conformity with Chapter 222, Section 222.17, Florida Statutes. ~
~
_ _ ~s!7L~V !
I was formerly a leget resident of _ _ _ . _ _ ~
(City) (State)
and I resided at l~~~ ~~~"~~_J_ However 1 have changed my domiCile
I eet and Numbery
ro and am and have been a bona fide resident of the State of Florida since i - - - day of
Kf _ _ , 191/t and f reside at ~0~ ~ _ _ - - - - -
(S t and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RQRIDA
and this statement is to be taken as my declaration of citizer:ship, actual lega! residence and domicile in the State of F{orida. ;
(Insert here any pertinent facts, such as sale of property or business, or relinquishment ot employment
at former domicile, removat of famity to new domicile, purchase of home, etc.)
?V °ECOROEO
~ p FILED
ST WC~L CD~NTT FLA:
' FCu== r~tTRAS ~1~
'f ~ CtEFK ~:1;' COURT
qc~f'F' •:~•'!~'E~
' ~ 9a FE8 ~ 3 16 PH'7Z }
~ - f
~ 223494 '
~ 3
~
~
z
;
~
~
~
~
0
~ I FURTHER CERTIFY that I will comply with all othe~ requirements of a leyal resi~ent of this State.
~
1 FURTHER CERTIFY that I have no intention to return to my former domiule, and I intend to remain in FORT
i
~ PIERCE, ~AINT LUCIE COUNTY, FlOR10A, permanently. ~TOI~ J. I~Ar1EY
~ '
~ , _ , - ~
~ , ame)
~ ~ . ~ = s
. . . .
`f ; _ ~ ~O~ - - -
`5 ' . ~ . (A s)
- - ' ,
' ~
. . ' y ZZ
'~s .
Sv~o~N to and lvascribed before me this day of , 19~ ~
-1 ~r•~:....:~:~.:
t
- ROQ~R rO1TRA5 - - -
C UIT COURT Notary Public ~
':4 f
' gy _ D.C. My Commission expires
;z; Rs bs ~xecuf~d i~ dupiicat~ and ori~inal Kl~el wifh Cl~ic G~cui! Courf, and duplisat~ with Tax As~essor.)
v_~
~o~ 1~9 ~~E 146~
~
-
s
-
-
_
,
-
_ -
_
. _ . . _ -
-