HomeMy WebLinkAbout1774 2~
:3'721
Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~
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51. LUCIE COUNTY, FlORIOA: {
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This ~s my declaration of ~om~cile and Citizensh~p in the State of Florida that I am filing this day in accordance and ;
~n conformity wilh Chapter 222, Section 222.17, Florida Statutes. ~
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1 was formerly a fegal resident of ROSedale Nee•York 3
(City) (State) s
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141-33 255 St. ~
and 1 resided at . . _ _ . _ _ _ However I have changed my domiCile .
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(Street and Number) ~
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fo and am and have been a bona fide ~esident of the State of Florida since ~ y _ day of ;
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/Vo v~,,, a f,e , ~ 9_ ~ and I reside at _ ~ ~ ~-Hi81 @- (B~1-e~~~ Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legal resiclence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of properry or business, or relinquishment of emptoyme~t
at former domicile, removal of family to new domicile, purchase of home, e1c.)
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RESIDEh'CE ;
2~3'~21 ~
~ ~EO ~E COlJM~Y flA~ ~
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'~1lpCER POItRAi t
~ CIERK CIf+CU~? CO
f RECORD VER~F~EO
' ~ 11 1136 AM'1t
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of This Sinte. ~
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~ 1 FURTHER CERTIFY that I have no intention to return to my former domiGle, and 1 intend to remain in FORT ~
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~ PIERCE, SAINT LUUE COUNTY, FLORIDA, permanently. C~~~ ~y~ ~
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~ FR.ANK DiMETRO
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~ - (Name) ~
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~ 111 Hialeah Ave. ~'t . Pierce, Fl. #
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- ' 1." • (Address) 33450
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' ~ ~ ' 11 th ~'ebruar
` ~ •S~qrn to'antl sukrscribed before me this day of _~L.___ , 19~~..
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•~R~4ER .POITRAS
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C CIRCUIT COURT Notary Public f
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' By _ U.C. My Commission expires - _ ~
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(To be execut~d i~ duplicat~ and oriyinal filed with Cl~rlc Circuit Courf, and duplipte with Tax Assessor.) ~
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= ~3 A 6~~K~~79 PAGE1 1~
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