HomeMy WebLinkAbout1566 Oeclaratio~ ot Dornicile a~~d Cltisenship . ~
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TO THE STATE AND COUNTY TAX ASSESSOR, 2~S'~?'~?
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Sl. LU~IE COUNTY, FIORIDA: ~
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Thix is my declaration of Domiule and Gitizenship in the Sta~e of Florida that I am filing this day in accordance and ~
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~n conformity with Chapter 222, Section 222.17, florida Statutes. ~
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1 was formerly a legal resident of Q""'`_~~ ~
(City) - ( te)
and I resided at _ v~ Q_~ _--__-__-wa - :
. However 1 have changed my domicife
reet and Number)
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to and am and have been a bona fide resident of the Stafe of Florida since _ ~_Z _ day of
.
~ _ and 1 ~eside at _ zO2G~ ~/G- '2~~
_ _
~ (Street a~d Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORiDA
and this statement is to be taken as my declaration of citizenship, actuai lega! residence and domicile in the State of Florida. (
(Insert here any pertinent facts, such as sale of properfy or business, or relinquishment of employment
at former domicile, ~emoval of family to new domicile, purchase of home, etc.) ;
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22357"~ ;
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ST. tUC:: c9UHTr Fl~. }
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1 FURTHER CERTIFY that I will compiy with ail ofher requirements of e legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domi~ile, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_
J ~ . . . . . . , ~/~/l C'~litiC L~~~~
_ (Name?
' • Everett W. Chandler
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. - ' F' - (Address)
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~ "Sv~r,or~Ya and subscribed before me this day of ~•~-~-~tit.~ ~ lq7
ROGER POITRAS
' K CIRCUIT COURT Notary Pubfic
BY D.C. My Commission expires
(To be ~x~cuMd in dupliute and ori~inal filed witb C{~rk Grcuit Court, snd duplieat~ with Tax Ass~ssor.)
Nn. 13 D~~XZ~ ~VE~~/V~/
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