HomeMy WebLinkAbout0477 Declaration ot DomiCile and Citizenship ~
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TO THE STATE AND COUNTY TAX ASSESSOR, ' 21V`~~7V8
51. lUC1E COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
~n conformity with Chapter 222, Sectio~ 222.17, Florida Statutes.
1 was formerly a legal resident of ---.:~L~1~'~/~~- -~°T~-~~-~-
~ ~Ciy) (State)
and I resided at ,_~~2'_~~~~~~ ~A However I have changcd my domicjle
Street and Numbe~)
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to and am and have been a bona fide ~esident of the Sfate of Florida since day of
----lll4~_/^c~~---- , 19 and I reside at ~/~/d /7L C - -
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, adual legal residence and domicile in the State of Flo~ida.
(Insert here any pertineni fads, such as sale of property or business, or relinquishment o~ -•mployment
at former domicile, removal of family to new domicile, purchase _of home, etc.)
Wilaon Sel! haa been in the Army stationed in Vietman ~
and ia back hoae to stay now
224908
j ftlEO ANO ltECORQEO
ST. WCIE COUNTY rLA. ~
i ROCER POITRAS ~
~ CIERK CI~CUIT COURT ~
~ AECORD VE~t!FtfO~..~.~..~.~
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~ I FURTHER CHtTIFl( that I will comply with all other requirements of s leyal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domit,ile, and I intend to remein in FORT
PIERCE, SAI[~,~. I.UCIE COUNTY, FLORIOA, permanently.
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~ Sworn to and suburibed before me this 6th day of YBrCh ~ 19 72
ROGER rOfTRAS
CIRGUIT COURT Notary Public
8y D.C. My Commission expires
~,k Ro b~ ~x~cut~d in dvplicat~ aed wi~inal fil~d wiNi Cl~ic Cirwk Court, and duptica» wi~h Tax Ass~or.)
go$~?.AO r~ 477
g;: Nv. ~ 3A
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