HomeMy WebLinkAbout1692 {
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Oeclaratio~ ot Domicile and Citizenship '
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~ 223653
TO lNE STATE AND COUNTY TAX ASSESSOR,
51. lUC1E COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accardance and
~n conformity with Chapte~ 222, Section 222.17, Flo~ida Statutes.
1 was formerly a legal resident of L~ERNE - MI~' '
(Ciy) (State) ~
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and 1 resided at _ ROLit / 1._~ _ g H~1 However t have changed my domitile
(Street and Number)
to and am and have been a bona fide resident of the State qf Florida since 26th_ day of
- _J~AU~~'? i9__7_?, and 1 reside ar __1~8 West ~len Dri~e. ~'t. Pierce,Fl .
(Street and Number)
FORT PIERCE. SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legat residence and domicile in the State of Florida. ~
(Insert hers any pertinent facts, such as sale of property or business, or relinquishment of employment a
at former domicile, removal of family to new domicite, purchase of home, etc.)
223653
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FllEO AND RECORpEp
ST. LUCIE COUNTY fLA. t
ROCER P01?RAS
RESIDENCE - RECORD'vERRFIEp
C~~~
F~010 I vs PM'72
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~ I FURTHER CERTIFY that I will comply with all other requirements of a leya) resident of this State.
~ I FURTHER CERTIFY that I have no intention to return to my former domiqile, and I intend to remain in FORT
~ PIERCE, 5.41NT IUCIE COUNTY, FLORIDA, permanently. .
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~ ~ JOHN PAI.I[ER
~ . ~ ~ . , (Nam
s$
~ l~ . 158 Wsst Glen Dri~e, l~t. Pieree, Fl.
_ (Address)
~ ~ - 33450
~ . : f~f.~~
- •~vrofn to and subscribed before me this ~ Oth day of _~ebTL1aT~ , 19~.
~'2
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ROGER rO1TRAS _ ~
Ct,ERK CIRCUiT COURT Notary Public ~
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i
gy _L D.C. My Commission expires ~
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~=y~~ Ro b~ ~x~cut~d in duplicat~ snd oripinal fif~d wilh CIKk Grcuit CouA, and duplicate with Tax Ass~u~or.)
dooK199 PACE1by~
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